Glycaemic control and therapeutic inertia in patients with CAD and T2DM: a cross-sectional study in the Department of Cardiology

Abstract

Abstract Background The purpose of this study was to evaluate glycemic control in type 2 diabetes mellitus (T2DM) patients with coronary artery disease in China, as well as to look into therapeutic inertia among cardiologists. Methods From June 2021 to December 2021, a descriptive cross-sectional study was conducted in the Department of Cardiology at Shanghai Ruijin Hospital in China. The method of convenience sampling was used. Patients with coronary artery disease (including acute and chronic coronary syndrome) and T2DM were included in the study. Patients with renal insufficiency (eGFR < 45 ml/min/1.73m2), heart failure (left ventricular ejection fraction, LVEF < 40%), and absence of an HbA1c value during hospitalization were excluded. SPSS 18.0 was used for statistical analysis. Results The proportion of diabetic patients achieving the HbA1c target (< 7.0%) among 358 participants was 39.11% (140/358). Glycaemic control was worse in patients with acute coronary syndromes than in those with chronic coronary syndromes (34.63% vs. 45.10%, P < 0.05). The blood pressure control rate was 25.70% (92/358, cut-off 130/80 mmHg), and 41.06% (147/358) of participants had LDL-C levels of < 1.8 mmol/L (70 mg/dL). In the hypoglycemic regimen, therapeutic inertia was present in 55.96% of the study subjects. However, the therapeutic inertia rate varies greatly depending on HbA1c level. The therapeutic inertia rate among patients with HbA1c ≥ 9.0% was significantly lower than the rates in the 7.0-7.9% and 8.0-8.9% groups (P < 0.05). Conclusions The Department of Cardiology's glycemic control rate of hospitalized T2DM patients is low, and cardiologists exhibit therapeutic inertia in hypoglycemic regimens.