Objective: To estimate the incidence of cardiovascular disease (CVD) events among T2DM patients across the number of diabetic or CHD RE complications.
Research Design and Methods: Adult (aged ≥18 years) hyperlipidemic patients diagnosed with T2DM who initiated statins and/or ezetimibe from January 2007 to June 2011 were identified retrospectively from the IMS LifeLink Pharmetrics Plus™ commercial claims database. The index date was the initiation date of the statin and/or ezetimibe after ≥ 12 months of continuous health plan eligibility. Incident CVD events among those with a history of multiple (if any) diabetic and CHD RE complications were assessed for ≥ 12 months post-index date. A subset analysis was performed among patients aged ≥ 40 years. A Cox proportional hazard model was performed to assess the relationship between number of complications and incident CVD events.
Results: A total of 136,854 hyperlipidemic patients had T2DM during the 12 months pre-index (baseline) period. The mean age was 56 years old (±10.5) and 55.8% of the population were male. Those with ≥ 1 complication(s) represented ~18% of the patients (17.9% with diabetic and 17.5% with CHD RE complications). Among patients with 0,1,2,3 and 4 diabetic complications, patients who had incident CVD events during follow-up ranged from 4.0%-15.7%. Among patients with 0,1,2,3 and 4 CHD RE complications, the number of patients with incident CVD events increased from 2.4% to 44.8% (Figure). Similar results were found among patients aged ≥40 years. After adjusting for age, gender, region, payer type and history of CVE, risk (hazard ratio) of incident CVD events increased as the number of diabetic or CHD RE complications increased compared to those without any complications.
Conclusions: T2DM patients with diabetic or CHD RE complications, despite being on standard lipid-lowering therapy have substantial residual risk for future CVD events compared to those without complications.