Patients with peripheral artery disease (PAD) are at a very high risk of cardiovascular events and strongly benefit from lowering LDL cholesterol (LDL-C). Current guidelines recommend an LDL-C target of at least <70mg/dl for these patients. PAD patients who also have diabetes are at an extremely high risk of cardiovascular events, and an LDL-C target of <55 mg/dl has been proposed for these patients. Whether the presence of type 2 diabetes (T2DM) affects LDL-C target achievement in PAD patients is unknown and is addressed in the present study. We investigated an unselected consecutive series of 481 patients with sonographically proven PAD, of whom 214 (44.5%) had T2DM. An LDL-C target of <70 mg/dl was met by 26.4% of PAD patients with T2DM and by 9.0% of nondiabetic PAD patients (p<0.001); an LDL-C target <55 mg/dl was met by 11.8% of T2DM patients and by 2.7% of nondiabetic patients (p<0.001). Logistic regression analysis showed that the presence of T2DM was an independent and strong predictor of LDL-C target achievement after multivariate adjustment including age, gender and statin use both for the <70 mg/dl target (OR 3.31 [1.93-5.68]; p<0.001) and for the <55 mg/dl target (OR 4.40 [1.83-10.51]; p<0.001). We conclude that T2DM is a strong and independent predictor of LDL-C target achievement among PAD patients; however, also among PAD patients with T2DM the majority does not even meet the liberal LDL-C target of <70 mg/dl.
S. Sternbauer: None. A. Vonbank: None. C. Heinzle: None. D. Zanolin-Purin: None. J.F. Dopheide: None. I. Baumgartner: None. B. Larcher: None. A. Mader: None. A. Leiherer: None. A. Muendlein: None. H. Drexel: None. C.H. Saely: None.