1Department of Endocrinology and Metabolism, Kyung Hee Medical Center, Kyung Hee University School of Medicine, Seoul, Korea
2Department of Medicine, Graduate School of Medicine, Kyung Hee University, Seoul, Korea
3Department of Endocrinology and Metabolism, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
4Outcomes Research/Real World Data Team, Viatris Korea, Seoul, Korea
5Department of Biostatistics, Korea University College of Medicine, Seoul, Korea
6Department of Endocrinology, Keimyung University Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea
7Department of Endocrinology and Metabolism, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
8Department of Endocrinology and Metabolism, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
9Department of Endocrinology, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea
10Department of Endocrinology and Metabolism, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
11Department of Endocrinology and Metabolism, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
12Department of Endocrinology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
13Department of Endocrinology and Metabolism, Jeju National University Hospital, Jeju National University College of Medicine, Jeju, Korea
14Department of Endocrinology, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea
15Department of Endocrinology, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea
16Department of Endocrinology and Metabolism, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
17Department of Endocrinology and Metabolism, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
18Department of Endocrinology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
19Division of Endocrinology and Metabolism, Department of Internal Medicine, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
Copyright © 2022 Korean Diabetes Association
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Guideline | CVD risk classification in T2DM | Target goal or management |
---|---|---|
Korea Diabetes Association 2019 |
Very High-I: established ASCVD | LDL-C <70 mg/dL |
Very High-II: target organ damage (albuminuria, eGFR <60 mL/min/1.73 m2 or retinopathy), or any CV risk factor (hypertension, smoking, family history of premature CAD, or HDL | ||
<40 mg/dL) High: others | LDL-C <100 mg/dL | |
European Society of Cardiology/European Atherosclerosis Society 2019 |
Very High-I: established ASCVD | LDL-C <55 mg/dL |
Very High-II: target organ damage (albuminuria, eGFR <30 mL/min/1.73 m2, retinopathy, or left ventricular hypertrophy) or ≥3 CV risk factors (age ≥50 years, hypertension, smoking, BMI ≥25 kg/m2, dyslipidemia) | ||
High: diabetes duration ≥10 years without target organ damage plus any CV risk factor | LDL-C <70 mg/dL | |
Moderate: diabetes duration <10 years without other CV risk factor | LDL-C <100 mg/dL | |
American Diabetes Association 2019 |
Very High-I: established ASCVD | High intensity statin |
Very High-II: age ≥40 years plus target organ damage (albuminuria, eGFR <60 mL/min/1.73 m2 or retinopathy) or any CV risk factor (hypertension, smoking, family history of premature CAD, or HDL <40 mg/dL) |
Variable | Total (n=2,000) |
---|---|
Age, yr | 62.6±12.0 |
Male sex | 1,117 (55.90) |
Body mass index, kg/m2 | 25.4±3.8 |
Dyslipidemia |
|
Yes | 1,640 (82.00) |
No | 360 (18.00) |
Family history of premature CAD | |
Yes | 49 (2.45) |
No | 850 (42.50) |
Unknown | 1,101 (55.05) |
Smoking history | |
Current smoker | 285 (14.25) |
Ex-smoker | 277 (13.85) |
Non-smoker | 880 (44.00) |
Unknown | 558 (27.90) |
HbA1c, % | 7.2±1.3 |
Diabetes duration, yr | 9.80±8.09 |
Atherosclerotic cardiovascular disease | 493 (24.70) |
Target organ damage | |
Yes | 510 (25.50) |
Proteinuria | 341 (17.10) |
Left ventricular hypertrophy | 25 (1.30) |
Retinopathy | 257 (12.90) |
Renal function | |
eGFR ≥60 mL/min/1.73 m2 | 1,710 (85.50) |
eGFR 30–59 mL/min/1.73 m2 | 246 (12.30) |
eGFR <30 mL/min/1.73 m2 | 44 (2.20) |
Blood pressure, mm Hg | |
Systolic | 128.2±14.7 |
Diastolic | 74.0±10.9 |
Lipid profile | |
Total cholesterol, mg/dL | 149.7±34.4 |
LDL-C, mg/dL | 80.3±28.2 |
HDL-C, mg/dL | 49.5±13.3 |
Triglyceride, mg/dL | 141.9±97.4 |
Variable | Total (n=2,000) |
---|---|
Lifestyle modification | 472 (23.5) |
Statin treatment | 1,455 (72.8) |
Statin monotherapy | 1,075 (73.9) |
Statin combined with other drugs | 380 (26.1) |
Statin-ezetimibe |
231 |
Statin-fibrate |
101 |
Statin-omega-3 fatty acids |
70 |
Others |
7 |
Lipid-lowering treatment other than statin | 73 (3.7) |
Ezetimibe |
21 |
Fibrate |
35 |
Omega-3 fatty acids |
36 |
CVD, cardiovascular disease; T2DM, type 2 diabetes mellitus; ASCVD, atherosclerotic cardiovascular disease; eGFR, estimated glomerular filtration rate; CV, cardiovascular; CAD, coronary artery disease; HDL, high-density lipoprotein; LDL-C, low-density lipoprotein cholesterol. 2019 Clinical practice guidelines for type 2 diabetes in Korea, 2019 ESC guidelines on diabetes, pre-diabetes, and cardiovascular disease developed in collaboration with the European Foundation for the Study of Diabetes (EASD), Cardiovascular disease and risk management standards of medical care in diabetes 2019, Statin dose was determined by 2018 American Heart Association (AHA)/American College of Cardiology (ACC)/American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR)/American Association Academy of Physician Assistants (AAPA)/Association of Black Cardiologists (ABC)/American College of Preventive Medicine (ACPM)/American Diabetes Association (ADA)/American Geriatrics Society (AGS)/American Pharmacists Association (APhA)/American Society for Preventive Cardiology (ASPC)/National Lipid Association (NLA)/and Preventive Cardiovascular Nurses Association (PCNA).
Values are presented as mean±standard deviation or number (%). CAD, coronary artery disease; HbA1c, glycosylated hemoglobin; eGFR, estimated glomerular filtration rate; LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol. Patients with a diagnosis of dyslipidemia or receiving any lipid-lowering medications, Diabetes duration was analyzed with data from 1,893 patients.
Values are presented as number (%). Multiple response items.