The management of dyslipidaemia in patients with type 2 diabetes mellitus receiving lipid-lowering drugs: A sub-analysis of the CEPHEUS findings

Abdullah Shehab, Khalid Al Rasadi, Mohamed Arafah, Ali T. Al-Hinai, Wael Al Mahmeed, Akshaya Srikanth Bhagavathula, Omer Al Tamimi, Shorook Al Herz, Faisal Al Anazi, Khalid Al Nemer, Othman Metwally, Akram Alkhadra, Mohammed Fakhry, Hossam Elghetany, Abdel Razak Medani, Afzal Hussein Yusufali, Obaid Al Jassim, Omar Al Hallaq, Fahad Omar Ahmed S. Baslaib, Mahmoud AlawadhiHaitham Amin, Khamis Al Hashmi, Abderrahim Oulhaj

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Dyslipidaemia is a risk factor for macrovascular complications in patients with type 2 diabetes mellitus (T2DM). Our aim was to assess the use of lipid lowering drugs (LLDs) in patients with T2DM and co-existing dyslipidaemia. Method: A multicentre, non-interventional survey conducted in 6 Middle Eastern countries (Bahrain, Oman, Qatar, United Arab Emirates, Kingdom of Saudi Arabia and Kuwait). Patients with T2DM (n = 3338) taking LLD treatment for ≥3 months with no dose change for ≥6 weeks were enrolled. Results: The mean age (SD) of T2DM patients was 56.6 ±10.6 years; the majority (99%) were on statin monotherapy. Only 48% of these patients achieved their low density lipoprotein cholesterol (LDL-C) goal and 67.7% of the patients had a high cardiovascular disease (CVD) risk according to the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III guidelines. Of those who achieved LDL-C goals (n=1589), approximately one-third were at very high CVD risk and the patients who had received statin monotherapy showed the highest proportion in LDL-C goal attainment, followed by those treated with fibrate monotherapy. In a multivariate logistic regression model, taking drugs daily (odds ratio, OR: 1.64, 95% CI 1.25, 2.15) and older age (OR: 1.09, 95% CI 1.01, 1.18) were significantly associated with better odds of attaining LDL-C target. In contrast, patients with higher levels of ApoA1 (OR: 0.73, 95% CI [0.67,0.79]), Metabolic Syndrome (OR: 0.64, 95% CI [0.53, 0.76]), higher CV risk (OR: 0.33, 95% CI 0.27, 0.41), those who forgot to take their medication (OR: 0.74, 95% CI 0.62,0.88) and those who stopped taking medication when cholesterol became normal (OR: 0.67, 95% CI 0.55,0.82) were significantly associated with lower odds of attaining LDL-C target. Conclusion: The results of this study highlight the suboptimal management of dyslipidaemia in T2DM patients at high and very high risk of CVD.

Original languageEnglish
Pages (from-to)368-375
Number of pages8
JournalCurrent Vascular Pharmacology
Volume16
Issue number4
DOIs
Publication statusPublished - Jan 1 2018

Fingerprint

Dyslipidemias
Type 2 Diabetes Mellitus
Lipids
LDL Cholesterol
Pharmaceutical Preparations
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Cardiovascular Diseases
Logistic Models
Bahrain
Qatar
Cholesterol
United Arab Emirates
Oman
Kuwait
Fibric Acids
Saudi Arabia
Odds Ratio
Guidelines
Education
Therapeutics

Keywords

  • Cardiovascular disease (CVD)
  • Centralized pan-middle east survey (CEPHEUS)
  • Dyslipidaemia
  • Lipid-lowering drugs (LLDs)
  • Low-density lipoprotein cholesterol (LDL-C)
  • Middle east
  • Type 2 diabetes mellitus (T2DM)

ASJC Scopus subject areas

  • Pharmacology
  • Cardiology and Cardiovascular Medicine

Cite this

The management of dyslipidaemia in patients with type 2 diabetes mellitus receiving lipid-lowering drugs : A sub-analysis of the CEPHEUS findings. / Shehab, Abdullah; Al Rasadi, Khalid; Arafah, Mohamed; Al-Hinai, Ali T.; Al Mahmeed, Wael; Bhagavathula, Akshaya Srikanth; Al Tamimi, Omer; Al Herz, Shorook; Al Anazi, Faisal; Al Nemer, Khalid; Metwally, Othman; Alkhadra, Akram; Fakhry, Mohammed; Elghetany, Hossam; Medani, Abdel Razak; Yusufali, Afzal Hussein; Al Jassim, Obaid; Al Hallaq, Omar; Baslaib, Fahad Omar Ahmed S.; Alawadhi, Mahmoud; Amin, Haitham; Al Hashmi, Khamis; Oulhaj, Abderrahim.

In: Current Vascular Pharmacology, Vol. 16, No. 4, 01.01.2018, p. 368-375.

Research output: Contribution to journalArticle

Shehab, A, Al Rasadi, K, Arafah, M, Al-Hinai, AT, Al Mahmeed, W, Bhagavathula, AS, Al Tamimi, O, Al Herz, S, Al Anazi, F, Al Nemer, K, Metwally, O, Alkhadra, A, Fakhry, M, Elghetany, H, Medani, AR, Yusufali, AH, Al Jassim, O, Al Hallaq, O, Baslaib, FOAS, Alawadhi, M, Amin, H, Al Hashmi, K & Oulhaj, A 2018, 'The management of dyslipidaemia in patients with type 2 diabetes mellitus receiving lipid-lowering drugs: A sub-analysis of the CEPHEUS findings', Current Vascular Pharmacology, vol. 16, no. 4, pp. 368-375. https://doi.org/10.2174/1570161115666170705153815
Shehab, Abdullah ; Al Rasadi, Khalid ; Arafah, Mohamed ; Al-Hinai, Ali T. ; Al Mahmeed, Wael ; Bhagavathula, Akshaya Srikanth ; Al Tamimi, Omer ; Al Herz, Shorook ; Al Anazi, Faisal ; Al Nemer, Khalid ; Metwally, Othman ; Alkhadra, Akram ; Fakhry, Mohammed ; Elghetany, Hossam ; Medani, Abdel Razak ; Yusufali, Afzal Hussein ; Al Jassim, Obaid ; Al Hallaq, Omar ; Baslaib, Fahad Omar Ahmed S. ; Alawadhi, Mahmoud ; Amin, Haitham ; Al Hashmi, Khamis ; Oulhaj, Abderrahim. / The management of dyslipidaemia in patients with type 2 diabetes mellitus receiving lipid-lowering drugs : A sub-analysis of the CEPHEUS findings. In: Current Vascular Pharmacology. 2018 ; Vol. 16, No. 4. pp. 368-375.
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abstract = "Background: Dyslipidaemia is a risk factor for macrovascular complications in patients with type 2 diabetes mellitus (T2DM). Our aim was to assess the use of lipid lowering drugs (LLDs) in patients with T2DM and co-existing dyslipidaemia. Method: A multicentre, non-interventional survey conducted in 6 Middle Eastern countries (Bahrain, Oman, Qatar, United Arab Emirates, Kingdom of Saudi Arabia and Kuwait). Patients with T2DM (n = 3338) taking LLD treatment for ≥3 months with no dose change for ≥6 weeks were enrolled. Results: The mean age (SD) of T2DM patients was 56.6 ±10.6 years; the majority (99{\%}) were on statin monotherapy. Only 48{\%} of these patients achieved their low density lipoprotein cholesterol (LDL-C) goal and 67.7{\%} of the patients had a high cardiovascular disease (CVD) risk according to the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III guidelines. Of those who achieved LDL-C goals (n=1589), approximately one-third were at very high CVD risk and the patients who had received statin monotherapy showed the highest proportion in LDL-C goal attainment, followed by those treated with fibrate monotherapy. In a multivariate logistic regression model, taking drugs daily (odds ratio, OR: 1.64, 95{\%} CI 1.25, 2.15) and older age (OR: 1.09, 95{\%} CI 1.01, 1.18) were significantly associated with better odds of attaining LDL-C target. In contrast, patients with higher levels of ApoA1 (OR: 0.73, 95{\%} CI [0.67,0.79]), Metabolic Syndrome (OR: 0.64, 95{\%} CI [0.53, 0.76]), higher CV risk (OR: 0.33, 95{\%} CI 0.27, 0.41), those who forgot to take their medication (OR: 0.74, 95{\%} CI 0.62,0.88) and those who stopped taking medication when cholesterol became normal (OR: 0.67, 95{\%} CI 0.55,0.82) were significantly associated with lower odds of attaining LDL-C target. Conclusion: The results of this study highlight the suboptimal management of dyslipidaemia in T2DM patients at high and very high risk of CVD.",
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TY - JOUR

T1 - The management of dyslipidaemia in patients with type 2 diabetes mellitus receiving lipid-lowering drugs

T2 - A sub-analysis of the CEPHEUS findings

AU - Shehab, Abdullah

AU - Al Rasadi, Khalid

AU - Arafah, Mohamed

AU - Al-Hinai, Ali T.

AU - Al Mahmeed, Wael

AU - Bhagavathula, Akshaya Srikanth

AU - Al Tamimi, Omer

AU - Al Herz, Shorook

AU - Al Anazi, Faisal

AU - Al Nemer, Khalid

AU - Metwally, Othman

AU - Alkhadra, Akram

AU - Fakhry, Mohammed

AU - Elghetany, Hossam

AU - Medani, Abdel Razak

AU - Yusufali, Afzal Hussein

AU - Al Jassim, Obaid

AU - Al Hallaq, Omar

AU - Baslaib, Fahad Omar Ahmed S.

AU - Alawadhi, Mahmoud

AU - Amin, Haitham

AU - Al Hashmi, Khamis

AU - Oulhaj, Abderrahim

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: Dyslipidaemia is a risk factor for macrovascular complications in patients with type 2 diabetes mellitus (T2DM). Our aim was to assess the use of lipid lowering drugs (LLDs) in patients with T2DM and co-existing dyslipidaemia. Method: A multicentre, non-interventional survey conducted in 6 Middle Eastern countries (Bahrain, Oman, Qatar, United Arab Emirates, Kingdom of Saudi Arabia and Kuwait). Patients with T2DM (n = 3338) taking LLD treatment for ≥3 months with no dose change for ≥6 weeks were enrolled. Results: The mean age (SD) of T2DM patients was 56.6 ±10.6 years; the majority (99%) were on statin monotherapy. Only 48% of these patients achieved their low density lipoprotein cholesterol (LDL-C) goal and 67.7% of the patients had a high cardiovascular disease (CVD) risk according to the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III guidelines. Of those who achieved LDL-C goals (n=1589), approximately one-third were at very high CVD risk and the patients who had received statin monotherapy showed the highest proportion in LDL-C goal attainment, followed by those treated with fibrate monotherapy. In a multivariate logistic regression model, taking drugs daily (odds ratio, OR: 1.64, 95% CI 1.25, 2.15) and older age (OR: 1.09, 95% CI 1.01, 1.18) were significantly associated with better odds of attaining LDL-C target. In contrast, patients with higher levels of ApoA1 (OR: 0.73, 95% CI [0.67,0.79]), Metabolic Syndrome (OR: 0.64, 95% CI [0.53, 0.76]), higher CV risk (OR: 0.33, 95% CI 0.27, 0.41), those who forgot to take their medication (OR: 0.74, 95% CI 0.62,0.88) and those who stopped taking medication when cholesterol became normal (OR: 0.67, 95% CI 0.55,0.82) were significantly associated with lower odds of attaining LDL-C target. Conclusion: The results of this study highlight the suboptimal management of dyslipidaemia in T2DM patients at high and very high risk of CVD.

AB - Background: Dyslipidaemia is a risk factor for macrovascular complications in patients with type 2 diabetes mellitus (T2DM). Our aim was to assess the use of lipid lowering drugs (LLDs) in patients with T2DM and co-existing dyslipidaemia. Method: A multicentre, non-interventional survey conducted in 6 Middle Eastern countries (Bahrain, Oman, Qatar, United Arab Emirates, Kingdom of Saudi Arabia and Kuwait). Patients with T2DM (n = 3338) taking LLD treatment for ≥3 months with no dose change for ≥6 weeks were enrolled. Results: The mean age (SD) of T2DM patients was 56.6 ±10.6 years; the majority (99%) were on statin monotherapy. Only 48% of these patients achieved their low density lipoprotein cholesterol (LDL-C) goal and 67.7% of the patients had a high cardiovascular disease (CVD) risk according to the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III guidelines. Of those who achieved LDL-C goals (n=1589), approximately one-third were at very high CVD risk and the patients who had received statin monotherapy showed the highest proportion in LDL-C goal attainment, followed by those treated with fibrate monotherapy. In a multivariate logistic regression model, taking drugs daily (odds ratio, OR: 1.64, 95% CI 1.25, 2.15) and older age (OR: 1.09, 95% CI 1.01, 1.18) were significantly associated with better odds of attaining LDL-C target. In contrast, patients with higher levels of ApoA1 (OR: 0.73, 95% CI [0.67,0.79]), Metabolic Syndrome (OR: 0.64, 95% CI [0.53, 0.76]), higher CV risk (OR: 0.33, 95% CI 0.27, 0.41), those who forgot to take their medication (OR: 0.74, 95% CI 0.62,0.88) and those who stopped taking medication when cholesterol became normal (OR: 0.67, 95% CI 0.55,0.82) were significantly associated with lower odds of attaining LDL-C target. Conclusion: The results of this study highlight the suboptimal management of dyslipidaemia in T2DM patients at high and very high risk of CVD.

KW - Cardiovascular disease (CVD)

KW - Centralized pan-middle east survey (CEPHEUS)

KW - Dyslipidaemia

KW - Lipid-lowering drugs (LLDs)

KW - Low-density lipoprotein cholesterol (LDL-C)

KW - Middle east

KW - Type 2 diabetes mellitus (T2DM)

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