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Table 1 Clinical characteristics associated with misperceived risk, use of LLT with at least high intensity lipid-lowering-treatment LLT (allowing at least 50% of LDL-c reduction) and achievement of guidelines-recommended LDL-c targets

From: Physicians’ misperceived cardiovascular risk and therapeutic inertia as determinants of low LDL-cholesterol targets achievement in diabetes

Characteristics Mean ± SD or N (%) Odds ratio of misclassified CV risk P* Odds ratio of being on high-intensity LLT P* Odds ratio of being at LDLc targets P*
Age (ea. 5 years) 65.5 ± 10.6 0.92 (0.86–0.99) 0.021 1.03 (0.97–1.09) 0.307 1.09 (1.00–1.17) 0.038
Sex (female) 1082 (40.0%) 1.55 (1.21–1.98) 0.0004 0.74 (0.60–0.91) 0.005 0.87 (0.64–1.18) 0.374
Type 2 diabetes 2560 (94.5%) 1.38 (0.75–2.54) 0.304 1.01 (0.64–1.58) 0.975 1.73 (0.66–4.54) 0.268
Diabetes duration 11.6 ± 8.6 0.97 (0.95–0.99) 0.004 1.01 (1.00–1.02) 0.144 1.01 (1.00–1.03) 0.052
Comorbidities
 Prior CVD events 732 (27.0%) 0.12 (0.06–0.21)  < 0.0001 4.02 (3.17–5.08)  < 0.0001 1.71 (1.27–2.32) 0.001
 Stroke 153 (5.6%) 1.01 (0.62–1.66) 0.967 0.45 (0.29–0.69) 0.000 1.22 (0.77–1.94) 0.402
 MI 609 (22.5%) 1.59 (0.70–3.62) 0.272 2.11 (1.28–3.47) 0.003 0.78 (0.48–1.26) 0.308
 Angina 102 (3.8%) 0.14 (0.05–0.36)  < 0.0001 2.76 (1.76–4.33)  < 0.0001 1.28 (0.58–2.81) 0.540
 PAD 156 (5.8%) 0.24 (0.10–0.55) 0.001 1.16 (0.72–1.86) 0.546 0.75 (0.43–1.30) 0.304
 Targ. organ damage 298 (11.0%) 0.21 (0.12–0.36)  < 0.0001 1.17 (0.88–1.57) 0.276 1.10 (0.75–1.59) 0.633
3 +  VD risk factors 773 (28.5%) 0.42 (0.26–0.67) 0.0003 1.45 (1.15–1.82) 0.002 0.86 (0.57–1.31) 0.487
DKD 1178 (43.5%) 1.15 (0.75–1.76) 0.523 1.04 (0.81–1.32) 0.776 0.93 (0.70–1.24) 0.613
 Albuminuria 796 (30.3%) 1.40 (0.87–2.25) 0.162 1.07 (0.82–1.41) 0.608 0.87 (0.62–1.24) 0.449
 CKD IV stage 46 (1.8%) 1.01 (0.48–2.10) 0.983 1.52 (0.85–2.73) 0.160 2.06 (0.85–5.02) 0.111
 Obesity 930 (34.3%) 0.98 (0.69–1.39) 0.903 1.18 (0.93–1.51) 0.178 0.74 (0.58–0.94) 0.013
 Hypertension 2110 (77.9%) 0.55 (0.35–0.86) 0.009 1.65 (1.22–2.23) 0.001 1.07 (0.75–1.53) 0.708
COPD 221 (8.2%) 0.92 (0.62–1.37) 0.677 0.72 (0.41–1.28) 0.263 0.71 (0.36–1.41) 0.326
Life-style
 Smoke habits
  Non smokers 1546 (57.1%) ref. 0.005 1.00 (1.00–1.00) 0.273 1.00 (1.00–1.00) 0.276
  Active smoker 554 (20.5%) 0.87 (0.64–1.17)   1.20 (0.91–1.57)   0.72 (0.47–1.11)  
  Prior smoker 608 (22.5%) 0.59 (0.43–0.81)   1.18 (0.92–1.52)   1.04 (0.74–1.47)  
 Reg. alcohol intake 835 (31.2%) 0.85 (0.64–1.13) 0.268 1.17 (0.90–1.51) 0.234 0.58 (0.40–0.84) 0.004
 Healthy diet
  No 490 (18.4%) ref. 0.010 ref. 0.297 ref. < 0.0001
  Occasionally 1629 (61.2%) 1.59 (1.14–2.21) 1.10 (0.83–1.45) 1.90 (1.20–3.02)  
  Regularly 543 (20.4%) 1.92 (1.31–2.82) 1.16 (0.83–1.62) 3.09 (1.86–5.13)  
 Regular physical activity 1157 (43.7%) 1.26 (0.92–1.74) 0.151 1.09 (0.86–1.37) 0.491 1.20 (0.86–1.67) 0.296
Clinical-laboratory findings
 BMI (kg/m2) 29.2 ± 6.0 0.99 (0.97–1.02) 0.661 1.01 (0.99–1.03) 0.250 1.01 (0.98–1.04) 0.639
 Waist (cm) 101.7 ± 14.3 0.99 (0.98–1.01) 0.323 1.01 (1.00–1.02) 0.239 1.00 (0.99–1.01) 0.839
 Systolic BP (mmHg) 133.0 ± 18.1 0.99 (0.98–1.00) 0.093 1.00 (0.99–1.01) 0.885 0.99 (0.98–1.00) 0.028
 Diastolic BP (mmHg) 81.4 ± 12.7 1.00 (0.99–1.02) 0.649 1.00 (0.99–1.01) 0.800 0.97 (0.96–0.99) 0.001
 eGFR (ml/min) 1.0 ± 0.3 1.01 (1.00–1.01) 0.170 1.00 (0.99–1.00) 0.048 1.00 (0.99–1.00) 0.219
 FPG (mg/dl) 76.0 ± 25.0 1.00 (0.99–1.00) 0.042 1.00 (1.00–1.00) 0.210 1.00 (0.99–1.00) 0.078
 Hba1c (%) 139.9 ± 37.4 0.90 (0.80–1.02) 0.109 1.07 (0.98–1.16) 0.118 0.88 (0.79–0.99) 0.034
 HDL-c (mg/dl) 47.1 ± 12.4 1.01 (1.00–1.02) 0.146 0.99 (0.98–1.00) 0.146 0.99 (0.98–1.00) 0.182
 Triglycerides (mg/dl) 153.5 ± 67.5 1.00 (1.00–1.00) 0.597 1.00 (1.00–1.00) 0.550 1.00 (0.99–1.00) 0.067
Antidiabetic treatments
 Diet alone 90 (3.3%) 2.34 (1.43–3.82) 0.001 0.59 (0.22–1.59) 0.296 0.78 (0.35–1.76) 0.552
 Metformin 1916 (70.8%) 1.03 (0.78–1.37) 0.813 1.01 (0.81–1.26) 0.920 1.07 (0.81–1.42) 0.620
 Sulphonylureas 217 (8.0%) 0.86 (0.55–1.34) 0.508 0.63 (0.42–0.96) 0.030 1.07 (0.70–1.64) 0.740
 Pioglitazone 97 (3.6%) 0.84 (0.43–1.66) 0.620 0.98 (0.57–1.68) 0.942 1.34 (0.66–2.71) 0.418
 DPP4i 593 (21.9%) 0.91 (0.69–1.21) 0.532 0.79 (0.59–1.05) 0.104 1.05 (0.77–1.41) 0.773
 GLP1RAs 515 (19.0%) 0.52 (0.39–0.69)  < 0.0001 1.23 (0.94–1.60) 0.136 1.12 (0.82–1.52) 0.469
 SGLT2i 564 (20.8%) 0.97 (0.68–1.38) 0.867 1.39 (1.07–1.81) 0.015 1.46 (1.02–2.10) 0.038
 Insulin 768 (28.4%) 0.76 (0.55–1.04) 0.089 1.37 (1.12–1.68) 0.003 1.02 (0.75–1.39) 0.909
Adherence/adverse effects
 Low-adherence 383 (19.5%) 0.73 (0.52–1.02) 0.067 1.55 (1.08–2.21) 0.016 0.85 (0.29–2.48) 0.770
 LLT-Adverse effects 201 (7.4%) 0.64 (0.38–1.08) 0.094 1.10 (0.73–1.67) 0.650 0.27 (0.10–0.68) 0.006
Physician starting treatments
 Diabetologist 1208 (44.6%) Ref. 0.769 Ref.  < 0.0001 Ref.  < 0.0001
 Cardiologist 784 (29.0%) 0.91 (0.67–1.24) 1.35 (1.06–1.71) 0.60 (0.42–0.85)  
 General-physician 712 (26.3%) 1.02 (0.75–1.38) 0.48 (0.36–0.65) 0.25 (0.15–0.40)  
  1. Odds ratio (OR) above 1 suggest higher probability of achieving each outcome while OR below 1 suggest lower probability
  2. MI myocardial infarction, PAD peripheral artery disease, DKD diabetic kidney disease, CKD IV stage subjects with eGFR < 30 ml/min, COPD chronic obstructive pulmonary disease, BMI body mass index, eGFR estimated glomerular filtration rate, FPG fasting plasma glucose
  3. *Analyses adjusted by age, sex and prior CVD events