Key result
Population-based criteria identify elevated apoB in ~39% of patients with LDL-C at goal.
Why the study?
Discordance rates between attainment of therapeutic goals for apoB and LDL-C or non-HDL-C in patients with type 2 diabetes and chronic kidney disease were not well characterized.
Cross-Sectional (n=152)
The choice of apoB treatment target criteria significantly alters the proportion of patients with type 2 diabetes and CKD identified as needing more intensive lipid-lowering therapy.
Different apoB criteria identify more T2DM/CKD patients for intensified therapy than guidelines; leaves open optimal thresholds.
This study analyses discordance rates between attainment of therapeutic goals for apolipoprotein B100 (apoB) and both low-density lipoprotein-cholesterol (LDL-C) and non-high-density lipoprotein-cholesterol (non-HDL-C) in a sample of 152 patients with type 2 diabetes and chronic kidney disease from Gran Canaria (Spain), using treatment targets recommended by the American Diabetes Association/American College of Cardiology (ADA/ACC), the European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) and by a Spanish population-based study. Among subjects with LDL-C levels at therapeutic goal, apoB was above target in 16.3% (ADA/ACC), 6.5% (ESC/EAS) and 39.1% (population-based criteria), and among subjects with non-HDL-C levels at therapeutic goal, apoB was above target in 10.5% (ADA/ACC), 1.2% (ESC/EAS) and 29.6% (population-based criteria). These findings show that clinical management would be very differently altered depending on the criteria used to set treatment targets for apoB. Cut-off points derived from population data identify a greater number of subjects suitable for a more intensive lipid-lowering therapy.
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Boronat et al. (2013) conducted a cross-sectional in type 2 diabetes and chronic kidney disease (n=152). Apolipoprotein B100 treatment targets was evaluated on Discordance rates between attainment of therapeutic goals for apoB and LDL-C/non-HDL-C. Population-based criteria identified apoB above target in 39.1% of patients with LDL-C at goal, compared to 16.3% for ADA/ACC and 6.5% for ESC/EAS criteria.
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