1786-PUB: Type 2 Diabetes and the Presence of PAD vs. CAD Are Strong and Independent Predictors of LDL-C Target Achievement in Statin-Treated Patients with Established Cardiovascular Disease Free

Low-density-lipoprotein cholesterol (LDL-C) target achievement is a cornerstone in the prevention of cardiovascular events in patients with atherosclerotic disease. Whether the presence of type 2 diabetes (T2DM) affects LDL-C target achievement in PAD and CAD patients is unclear and is addressed in the present study. We enrolled a large high-risk cohort of 813 statin treated patients with established cardiovascular disease, 568 patients with angiographically proven stable CAD and 245 patients with sonographically proven peripheral artery disease (PAD). Diabetes was diagnosed according to ADA criteria. LDL-C overall was significantly lower in patients with T2DM (n=307) than in those who did not have T2DM (104±38 vs. 117±37; p<0.001) and in patients with PAD when compared to those with CAD (97±35 vs. 118±38 mg/dl; p <0.001). The LDL target of <55 mg/dl was met by 5.8% of PAD patients and by 2.3% of CAD patients (p=0.012). In logistic regression analysis the presence of T2DM was an independent and strong predictor of LDL-C target achievement after multivariate adjustment including age, gender, BMI and CAD vs PAD (OR 2.77 [1.21-6.39]; p =0.016); conversely the presence of PAD vs CAD predicted LDL-C target achievement after multivariate adjustment including T2DM (OR 2.32 [1.06-5.05]; p=0.034) We conclude that T2DM and the presence of PAD vs. CAD are a strong and independent predictors of LDL-C target achievement in statin treated patients with established cardiovascular disease. However, only a minority of these patients meets the current LDL-C target of <55 mg/dl.