Optimal LDL cholesterol levels in young and old patients with type 2 diabetes for secondary prevention of cardiovascular diseases are differentopen access
- Authors
- Jeong, Chaiho; Kim, Bongseong; Kim, Jinyoung; Baek, Hansang; Kim, Mee Kyoung; Sohn, Tae-Seo; Baek, Ki-Hyun; Song, Ki-Ho; Son, Hyun-Shik; Han, Kyungdo; Kwon, Hyuk-Sang
- Issue Date
- Nov-2023
- Publisher
- BIOSCIENTIFICA LTD
- Keywords
- type 2 diabetes mellitus; LDL cholesterol; diabetes complications; cardiovascular diseases
- Citation
- ENDOCRINE CONNECTIONS, v.12, no.11
- Journal Title
- ENDOCRINE CONNECTIONS
- Volume
- 12
- Number
- 11
- URI
- https://scholarworks.bwise.kr/ssu/handle/2018.sw.ssu/44655
- DOI
- 10.1530/EC-23-0142
- ISSN
- 2049-3614
- Abstract
- Objective: Real-world-based population data about the optimal low-density lipoprotein cholesterol (LDL-C) level for preventing cardiovascular disease in very high-risk populations is scarce. Methods: From 2009 to 2012, 26,922 people aged >= 40 years with type 2 diabetes mellitus (T2DM) who had a history of percutaneous coronary intervention (PCI) were analyzed. Data from the Korean National Health Insurance System were used. They were followed up to the date of a cardiovascular event or the time to death, or until December 31, 2018. Endpoints were recurrent PCI, newly stroke or heart failure, cardiovascular death, and all-cause death. Participants were divided into the following categories according to LDL-C level: <55 mg/dL, 55-69 mg/dL, 70-99 mg/dL, 100-129 mg/dL, 130-159 mg/dL, and >= 160 mg/dL. Results: Compared to LDL-C < 55 mg/dL, the hazard ratios (HR) for re-PCI and stroke increased linearly with increasing LDL-C level in the population < 65 years. However, in >= 65 years old, HRs for re-PCI and stroke in LDL-C = 55-69 mg/dL were 0.97 (95% CI: 0.85-1.11) and 0.96 (95% CI: 0.79-2.23), respectively. The optimal range with the lowest HR for heart failure and all-cause mortality were LDL-C = 70-99 mg/dL and LDL-C = 55-69 mg/dL, respectively, in all age groups (HR: 0.99, 95% CI: 0.91-1.08 and HR: 0.91, 95% CI: 0.81-1.01). Conclusion: LDL-C level below 55 mg/dL appears to be optimal in T2DM patients with established cardiovascular disease aged < 65 years, while an LDL-C level of 55-69 mg/dL may be optimal for preventing recurrent PCI and stroke in patients over 65 years old.
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