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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
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Cardiovascular Diabetology

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