{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T20:11:53Z","timestamp":1782159113759,"version":"3.54.5"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,3,7]],"date-time":"2023-03-07T00:00:00Z","timestamp":1678147200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100002429","name":"Amgen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002429","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To examine improvement in the use of optimal medical therapy (OMT) for secondary prevention in patients with atherosclerotic cardiovascular disease (ASCVD) and diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      Patients with ASCVD (coronary, cerebrovascular, peripheral) and low\u2010density lipoprotein\u2010cholesterol of 70\u2009mg\/dl or higher were enrolled from December 2016 to July 2018 from 107 US sites\/physicians (47% cardiology, 41% primary care, 12% other) and prospectively followed for 2\u2009years (current analysis restricted to subgroup with diabetes). OMT was defined as high\u2010intensity lipid\u2010lowering (high\u2010intensity statin, any statin + ezetimibe, proprotein convertase subtilisin\/kexin type 9 inhibitor), antithrombotic (antiplatelet or anticoagulant), angiotensin\u2010converting enzyme\u2010inhibitor\/angiotensin II receptor blocker\/angiotensin receptor neprilysin inhibitor (ACE\u2010I\/ARB\/ARNI) (excluding glomerular filtration rate [GFR]\u2009&lt;\u200930\u2009ml\/min\/1.73m\n                      <jats:sup>2<\/jats:sup>\n                      ) and sodium\u2010glucose co\u2010transporter\u20102 inhibitor (SGLT2i)\/glucagon\u2010like peptide\u20101 receptor agonist (GLP\u20101 RA) (excluding GFR\u2009&lt;\u200930\u2009ml\/min\/1.73m\n                      <jats:sup>2<\/jats:sup>\n                      and type 1 diabetes).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 1590 patients with ASCVD and diabetes (96% type 2 diabetes), 58% were on high\u2010intensity lipid\u2010lowering therapy at the end of follow\u2010up, 87% antithrombotic, 71% ACE\u2010I\/ARB\/ARNI and 17% SGLT2i\/GLP\u20101 RA. Overall, 11% of patients received comprehensive OMT, which modestly improved over time (vs. 8% at baseline;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.002). Patients treated by cardiologists (vs. non\u2010cardiologists) were more likely to be on high\u2010intensity lipid lowering, but less likely to be on an SGLT2i\/GLP\u20101 RA, and thus had lower rates of composite OMT (7.8% vs. 13.7%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001). In a hierarchical multivariable model, older age was associated with lower odds of OMT (OR 0.74 per 10\u2009years, 95% CI 0.60\u20100.90), whereas private insurance (OR 1.93, 95% CI 1.32\u20102.84) and coronary disease (OR 1.62, 95% CI 1.01\u20102.61) were associated with higher odds. The median odds ratio was 1.82 (95% CI 1.03\u20107.32), indicating a moderate variability in OMT use, independent of patient factors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We found suboptimal use of secondary prevention in US patients with ASCVD and diabetes, with minimal improvement over time. Further efforts are needed to improve the use of secondary prevention therapies in these patients with high residual risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.15032","type":"journal-article","created":{"date-parts":[[2023,2,27]],"date-time":"2023-02-27T03:34:54Z","timestamp":1677468894000},"page":"1750-1757","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Use of optimal medical therapy in patients with diabetes and atherosclerotic cardiovascular disease: Insights from a prospective longitudinal cohort study"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3367-0302","authenticated-orcid":false,"given":"Suzanne V.","family":"Arnold","sequence":"first","affiliation":[{"name":"Saint Luke's Mid America Heart Institute and University of Missouri\u2010Kansas City  Kansas City Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James A.","family":"de Lemos","sequence":"additional","affiliation":[{"name":"Division of Cardiology University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke","family":"Zheng","sequence":"additional","affiliation":[{"name":"Baim Institute for Clinical Research  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert S.","family":"Rosenson","sequence":"additional","affiliation":[{"name":"The Cardiometabolic Disorders Unit Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christie M.","family":"Ballantyne","sequence":"additional","affiliation":[{"name":"Department of Medicine Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shushama","family":"Alam","sequence":"additional","affiliation":[{"name":"Amgen Inc.  Thousand Oaks California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepak L.","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Mount Sinai Heart, Icahn School of Medicine at Mount Sinai Health System  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4596-2791","authenticated-orcid":false,"given":"Christopher P.","family":"Cannon","sequence":"additional","affiliation":[{"name":"Baim Institute for Clinical Research  Boston Massachusetts USA"},{"name":"Mount Sinai Heart, Icahn School of Medicine at Mount Sinai Health System  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3750-9789","authenticated-orcid":false,"given":"Mikhail","family":"Kosiborod","sequence":"additional","affiliation":[{"name":"Saint Luke's Mid America Heart Institute and University of Missouri\u2010Kansas City  Kansas City Missouri USA"},{"name":"The George Institute for Global Health  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the GOULD Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3,7]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.014796"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.06.019"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2020.4511"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-8587(17)30412-6"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.119.041730"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2019.10.014"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc22-S010"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000766"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.09.020"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc18-S008"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-022-01495-8"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.05.048"},{"key":"e_1_2_8_14_1","unstructured":"Echouffo\u2010TcheuguiJB TurchinA RosensonRS et al.Quality of care among patients with diabetes and cerebrovascular disease. Insights from The Diabetes Collaborative Registry. under review."},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1225648"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2013-303640"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.021314"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.297.11.1197"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjcvp\/pvz058"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2020.03.017"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.120.007682"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1504720"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1611925"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1603827"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1607141"}],"container-title":["Diabetes, Obesity and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dom.15032","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/dom.15032","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/dom-pubs.pericles-prod.literatumonline.com\/doi\/pdf\/10.1111\/dom.15032","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T02:46:14Z","timestamp":1761878774000},"score":1,"resource":{"primary":{"URL":"https:\/\/dom-pubs.pericles-prod.literatumonline.com\/doi\/10.1111\/dom.15032"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,7]]},"references-count":24,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,6]]}},"alternative-id":["10.1111\/dom.15032"],"URL":"https:\/\/doi.org\/10.1111\/dom.15032","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.1111\/DOM.15032\/v2\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15032\/v2\/review4","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15032\/v2\/review5","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15032\/v2\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15032\/v2\/review3","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15032\/v2\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15032\/v3\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15032\/v1\/review3","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15032\/v1\/review4","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15032\/v1\/review5","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15032\/v1\/review6","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15032\/v1\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15032\/v1\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15032\/v1\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15032\/v2\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15032\/v3\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1111\/DOM.15032\/v1\/review7","asserted-by":"object"}]},"ISSN":["1462-8902","1463-1326"],"issn-type":[{"value":"1462-8902","type":"print"},{"value":"1463-1326","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,7]]},"assertion":[{"value":"2022-11-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-02-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-03-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}