Comparison of type 2 diabetes patients identified for primary prevention of coronary heart disease with statin treatment according to Adult Treatment Panel III and Framingham model

Objective: To determine the difference between number of type 2 diabetic patients identified for Coronary Heart Disease (CHD) primary prevention with statins by Framingham model for calculation of 10-year CHD absolute risk and Adult Treatment Panel (ATP) III Guidelines. Material and methods: Observational, cross-sectional study including 516 type 2 diabetic patients with no arterial disease (CHD, cerebrovascular disease or peripheral arterial disease), no prior hypolipaemic treatment, aged 30-65 years, receiving insulin treatment for 6 months. Patients were identified for CHD primary prevention with statin if LDL cholesterol was higher than 2.6 mmol/l according to ATP III Guidelines, and if 10-year CHD absolute risk was higher than 15% accompanied by total cholesterol higher than 5.0 mmol/l according to Framingham model. Results: Out of 516 patients, 113 were not identified and 174 were identified for primary prevention with both methods. In addition, 58 patients were identified for primary prevention only with Framingham model, and 171 were identified for primary prevention only with ATP III. Overall, 232 patients were identified with Framingham model, and 345 were identified with ATP III (p<0.001). Conclusion: CHD primary prevention with statin should be initated in majority of type 2 diabetic patients, whereas ATP III Guidelines identify significantly more patients for primary prevention with statins compared to Framingham model having both clinical and health economics implications.