Skip to main content

Achievement of guideline-based lipid goals among very-high-risk patients with atherosclerotic cardiovascular disease and type 2 diabetes: results in 213,380 individuals from the cvMOBIUS2 registry.

Publication ,  Journal Article
Shoji, S; Shah, NP; Shrader, P; Thomas, LE; Arnold, JD; Dhalwani, NN; Thomas, NA; Kalich, B; Priest, EL; Syed, M; Wójcik, C; Peterson, ED; Navar, AM
Published in: Am J Prev Cardiol
March 2025

OBJECTIVE: Lowering lipid to reach guideline-indicated goals significantly reduces cardiovascular outcomes in very-high-risk (VHR) patients with atherosclerotic cardiovascular disease (ASCVD) and type 2 diabetes (DM2). How well VHR patients currently achieve these goals in community practice is unknown. METHODS: VHR patients with ASCVD and DM2 were identified across 14 US healthcare systems using electronic health records between 1/1/2021-12/31/2022. Achievement of guideline-based lipid goals was determined according to the 2018 AHA/ACC/Multisociety guideline, defined as either having a low-density lipoprotein-cholesterol <70 mg/dL or receiving maximal lipid-lowering therapy (i.e., on a PCSK9i monoclonal antibody). Multivariable logistic regression was used to evaluate factors associated with the achievement of these goals. RESULTS: Among 213,380 eligible patients (median age 71.0 years, 42 % women), 51.8 % achieved guideline-based lipid goals. Female sex (odds ratio [OR], 0.64; 95 % confidence interval [CI], 0.61-0.66), Black race (OR, 0.67; 95 % CI, 0.63-0.72 vs white race), and those on Medicaid (OR, 0.92; 95 % CI, 0.86-0.97 vs Medicare) were associated with a lower likelihood of achieving guideline-based lipid goals. Overall, 76.0 % of patients were on statin, 40.5 % were on a high-intensity statin and only 5.8 % were on a statin in combination with ezetimibe or a PCSK9i monoclonal antibody. CONCLUSION: Almost half of all VHR patients with ASCVD and DM2 do not achieve current guideline lipid goals. Women, Black individuals, and those on Medicaid were significantly less likely to achieve these goals relative to their counterparts. Further targeted quality improvement interventions are needed to improve the equitable achievement of guideline-based lipid goals.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Am J Prev Cardiol

DOI

EISSN

2666-6677

Publication Date

March 2025

Volume

21

Start / End Page

100921

Location

Netherlands

Related Subject Headings

  • 3201 Cardiovascular medicine and haematology
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Shoji, S., Shah, N. P., Shrader, P., Thomas, L. E., Arnold, J. D., Dhalwani, N. N., … Navar, A. M. (2025). Achievement of guideline-based lipid goals among very-high-risk patients with atherosclerotic cardiovascular disease and type 2 diabetes: results in 213,380 individuals from the cvMOBIUS2 registry. Am J Prev Cardiol, 21, 100921. https://doi.org/10.1016/j.ajpc.2024.100921
Shoji, Satoshi, Nishant P. Shah, Peter Shrader, Laine E. Thomas, Jonathan D. Arnold, Nafeesa N. Dhalwani, Neena A. Thomas, et al. “Achievement of guideline-based lipid goals among very-high-risk patients with atherosclerotic cardiovascular disease and type 2 diabetes: results in 213,380 individuals from the cvMOBIUS2 registry.Am J Prev Cardiol 21 (March 2025): 100921. https://doi.org/10.1016/j.ajpc.2024.100921.
Shoji S, Shah NP, Shrader P, Thomas LE, Arnold JD, Dhalwani NN, Thomas NA, Kalich B, Priest EL, Syed M, Wójcik C, Peterson ED, Navar AM. Achievement of guideline-based lipid goals among very-high-risk patients with atherosclerotic cardiovascular disease and type 2 diabetes: results in 213,380 individuals from the cvMOBIUS2 registry. Am J Prev Cardiol. 2025 Mar;21:100921.

Published In

Am J Prev Cardiol

DOI

EISSN

2666-6677

Publication Date

March 2025

Volume

21

Start / End Page

100921

Location

Netherlands

Related Subject Headings

  • 3201 Cardiovascular medicine and haematology