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Pharmacotherapy: Pharmacokinetics and Pharmacodynamics (including: ADE, TDM, DUE)
Clinical evaluation of the use of statins for diabetic dyslipidaemia, especially in The Seoul Veterans Hospital
  1. N.Y. Kim,
  2. S.Y. Baeck,
  3. S.M. Nam
  1. 1Seoul veterans hospital, Department of pharmacy, Seoul, Korea South

Abstract

Background In diabetic patients, cardiovascular disease (CVD) is known to be the leading cause of mortality. Because dyslipidaemia can cause CVD, the management of dyslipidaemia is very important, for example by using statins to reduce low density lipoprotein cholesterol (LDL-C).

Purpose To evaluate the use of stains in the management of dyslipidaemia in diabetic patients, based on the updated National Cholesterol Education Program Adult Treatment Panel 3 (NCEP ATP3) guidelines and American Diabetes Association (ADA) guidelines.

Materials and methods The authors retrospectively evaluated the lipid profiles of diabetic outpatients (age >40), who started statins for the first time during the first half of 2010. The criteria of evaluation on starting statins were high LDL-C level (over 100 mg/dl) or 70 mg/dl with CVD: the goals of treatment were LDL-C <100 mg/dl or <70 mg/dl with CVD.

Results The patients totalled 69 (100% male), their mean age was 66±5. Among them, there were 56 patients with CVD (81%). 68(99%) had their cholesterol level measured before treating with statins. The cholesterol level was measured again on average 167 days after starting to take statins. The mean initial LDL-C level was 136±16 mg/dl. 99% (n=68) met the criteria for starting statins. After taking statins, their mean level fell to 90±29 mg/dl. So most patients missed the target and HDL-C levels showed an average reduction of 43±8 mg/dl. Only 26% (n=18) of patients reached the guideline goals. Atorvastatin was the most frequently used the statins (n=43, 43%). 13% (n=9) of patients changed to the other drugs, but no patients stopped taking their medicine because of complications.

Conclusions The authors found that 98% of our patients followed the guideline for initiation of statins. But only 26% of patients reached the NCEP ATP3's updated guidelines. So The authors recommend shortening the time to test to check LDL-C after starting the statins.

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