Diabetic patients with CHD were more likely to achieve LDL cholesterol <55 mg/dL within 3 months of cardiac rehabilitation compared to nondiabetic patients (OR 1.9; 95% CI 1.2 to 2.9).
Observational (n=1,100)
Yes
Does lipid-lowering therapy during cardiac rehabilitation improve LDL cholesterol levels differently in CHD patients with versus without diabetes mellitus?
Lipid-lowering therapy during cardiac rehabilitation effectively reduces LDL cholesterol in CHD patients, with diabetic patients achieving target levels faster than non-diabetic patients.
Effect estimate: OR 1.9 (95% CI 1.2 to 2.9)
Background: Cardiac rehabilitation (CR) in patients with coronary heart disease (CHD) increases adherence to a healthy lifestyle and to secondary preventive medication. A notable example of such medication is lipid-lowering therapy (LLT). LLT during CR improves quality of life and prognosis, and thus is particularly relevant for patients with diabetes mellitus, which is a major risk factor for CHD. Design: A prospective, multicenter registry study with patients from six rehabilitation centers in Germany. Methods: During CR, 1100 patients with a minimum age of 18 years and CHD documented by coronary angiography were included in a LLT registry. Results: In 369 patients (33.9%), diabetes mellitus was diagnosed. Diabetic patients were older (65.5 ± 9.0 vs. 62.2 ± 10.9 years, p < 0.001) than nondiabetic patients and were more likely to be obese (BMI: 30.2 ± 5.2 kg/m2 vs. 27.8 ± 4.2 kg/m2, p < 0.001). Analysis indicated that diabetic patients were more likely to show LDL cholesterol levels below 55 mg/dL than patients without diabetes at the start of CR (Odds Ratio (OR) 1.9; 95% CI 1.3 to 2.9) until 3 months of follow-up (OR 1.9; 95% CI 1.2 to 2.9). During 12 months of follow-up, overall and LDL cholesterol levels decreased within the first 3 months and remained at the lower level thereafter (p < 0.001), irrespective of prevalent diabetes. At the end of the follow-up period, LDL cholesterol did not differ significantly between patients with or without diabetes mellitus (p = 0.413). Conclusion: Within 3 months after CR, total and LDL cholesterol were significantly reduced, irrespective of prevalent diabetes mellitus. In addition, CHD patients with diabetes responded faster to LTT than nondiabetic patients, suggesting that diabetic patients benefit more from LLT treatment during CR.
Wittlinger et al. (Mon,) conducted a observational in Coronary heart disease and diabetes mellitus (n=1,100). Lipid-lowering therapy during cardiac rehabilitation vs. Patients without diabetes was evaluated on LDL cholesterol levels below 55 mg/dL until 3 months of follow-up (OR 1.9, 95% CI 1.2 to 2.9). Diabetic patients with CHD were more likely to achieve LDL cholesterol <55 mg/dL within 3 months of cardiac rehabilitation compared to nondiabetic patients (OR 1.9; 95% CI 1.2 to 2.9).
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