Deepak Bhatt, MD: Ideal Lipid Management in Diabetic Patients with CAD

With so much focus in recent years, the recommendations and highlights from the lipid management portion of the American Heart Association’s new scientific statement discussing both coronary artery disease (CAD) and type 2 diabetes (T2D) are among the most insightful and anticipated.

As patients with diabetes at a risk for a multitude of dyslipidemias, the statement outlines use of statin therapies, non-statin LDL lowering therapies, and non-LDL target therapies based on clinical data and published studies from recent years.

Statin-based therapies remain as a first-line treatment for LDL-C lowering, but the scientific statement from the AHA highlights apparent benefits and risks of its use in diabetics patients as compared to nondiabetics. Overall, the statement encourages use of statins as the risk-benefit ratio favors administration in patients with CAD and T2D.

The statement, which was created by the AHA’s Council on Lifestyle and Cardiometabolic Health and Council on Clinical Cardiology, also details the use of PCSK9 inhibitors, such as evolocumab (Repatha) and alirocumab (Praluent), and the impact increased availability has had on patients when used in addition to maximally-tolerated statin therapy. Included in the non-LDL target therapy subsection of the statement, the authors highlight the REDUCE-IT trial and the apparent cardiovascular benefits observed in patients receiving icosapent ethyl (Vascepa).

For more on the scientific statement and lipid management, HCPLive® caught up with council vice chair and statement co-author Deepak Bhatt, MD, MPH, executive director of Interventional Cardiovascular Programs at Brigham and Women’s Hospital.

This scientific statement, “Clinical Management of Stable Coronary Artery Disease in Patients With Type 2 Diabetes Mellitus,” was published online in Circulation.