Predictors of Nonuse of a High‐Potency Statin After an Acute Coronary Syndrome: Insights From the Stabilization of Plaques Using Darapladib‐Thrombolysis in Myocardial Infarction 52 (SOLID‐TIMI 52) Trial

Eisen, Alon; Cannon, Christopher P.; Braunwald, Eugene; Steen, Dylan; Zhou, Jing; Goodrich, Erica L.; Im, KyungAh; Dalby, Anthony J.; Špinar, Jindřich; Daga, Shruti; Lukas, Mary Ann; O’Donoghue, Michelle L.

doi:10.1161/jaha.116.004332

Cited by 8 publications

(7 citation statements)

References 24 publications

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“…Data have shown that, in patients with recent ACS, HIS provided greater protection against death or major cardiovascular events than LMIS [ 7 ], emphasizing the need for adherence to guideline-directed statin use in ACS [ 13 ]. In a recent study, older age, female sex, renal dysfunction, and heart failure during hospital admission were the most common baseline characteristics of non-use of “high-potency statins” [ 25 ]. Factors that have been linked with an increased likelihood of being prescribed a HIS in high CV risk patients include male sex [ 21 ], no previous statin use [ 26 , 27 ], younger age [ 28 ], presence of hypertension [ 28 ], and receiving prescription from a cardiologist [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Statin Utilization Patterns and Outcomes for Patients with Acute Coronary Syndrome During and Following Inpatient Admissions

Boklage

Malangone-Monaco

López-González

et al. 2018

Cardiovasc Drugs Ther

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PurposeHigh-intensity statins (HIS) are recommended by current treatment guidelines for patients with clinical atherosclerotic cardiovascular disease and should be administered soon after an acute coronary syndrome (ACS) event and maintained thereafter. However, adherence to guidelines remains adequate. Statin utilization patterns during index hospitalization and the first year after ACS event, and the association between statin utilization and post-discharge clinical and economic outcomes, are described.MethodsRetrospective, observational study of US adults from the MarketScan Research Databases (2002–2014) with ≥ 1 inpatient admission for ACS and no evidence of previous ACS event < 12 months prior to index.ResultsIn total, 7802 patients met inclusion criteria. The most common index hospitalization primary diagnosis was myocardial infarction (94.6%). In the 3-month period before ACS admission, 3.4 and 14.9% of patients received HIS or low-to-moderate intensity statin, versus 13.2 and 30.7% during index hospitalization, and 16.4 and 45.1% in the year of follow-up. Of 1336 patients with a statin prescription filled on/after discharge, 53.2% filled prescriptions within 15 days of discharge and 14.9% delayed for > 91 days. The most common post-index hospital admissions for cardiovascular events were due to recurrent ACS (incidence rate = 115.2), heart failure (110.0), and revascularization (76.4). During follow-up, 2355 patients (30.2%) had all-cause inpatient admissions and 1136 (14.6%) had cardiovascular-specific admissions; mean all-cause medical and healthcare costs were $2456 and $2870, respectively, per patient per month.ConclusionsStatin dosing and utilization of HIS remains lower than recommended in current treatment guidelines, leaving patients at considerable risk of subsequent cardiovascular events.Electronic supplementary materialThe online version of this article (10.1007/s10557-018-6800-3) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Statin Utilization Patterns and Outcomes for Patients with Acute Coronary Syndrome During and Following Inpatient Admissions

Boklage

Malangone-Monaco

López-González

et al. 2018

Cardiovasc Drugs Ther

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“…Eighteen studies did not measure and categorize the non-responders [6], [7], [9], [13], [14], [15], [16], [17], [18], [19], [20], [21], [22], [23], [24], [25], [26]. There were nine studies [10], [18], [24], [27], [28], [29], [30], [31], [32] collecting data on statin use directly from the patients either by interview or selfreporting. By assessing the quality among the selected studies related to question number 13, missing data/ loss to follow-up was higher than 20% in the three studies [28], [33], [34].…”

Section: Study Qualitymentioning

confidence: 99%

“…Referring to question number 18, six studies [8], [15], [21], [35], [36], [37] did not report their study limitation in the discussion part. Thirteen out of 41 studies declared their conflict of interest according to question number 19 in the checklist [9], [10], [16], [18], [19], [24], [26], [28], [33], [34], [38], [39], [40]. Twelve studies did not receive the ethic committee approval nor the participant consent [6], [8], [14], [19], [21], [24], [25], [26], [33], [37], [38], [41].…”

Section: Study Qualitymentioning

confidence: 99%

“…The guideline from American Heart Journal had given their recommendation to initiate or continue statin therapy among patients with clinical or high-risk symptoms of ASCVD since 2013 [4] and still stated in the updated version [2], [5]. Current evidence also revealed that statin could prevent major adverse cardiac events, cardiac death, and re-hospitalization among ACS patients [6], [7], [8], [9], [10]. Although the guidelines and current evidence consistently revealed by two reviewers.…”

Section: Introductionmentioning

confidence: 99%

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Statin Utilization among Patients with Acute Coronary Syndrome: Systematic Review

Dewi¹,

Thavorncharoensap²

2021

Open Access Maced J Med Sci

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BACKGROUND: The early use of statin with intensive regimen has been recommended by the recent guidelines as the prevention of acute coronary syndrome (ACS) related events among the high-risk patients. Meanwhile, the inconsistent statin utilization for targeted patient in current practice is still an issue. AIM: This study aims to review the utilization rate of statin among patients with ACS. METHODS: A systematic search of relevant studies published between inceptions to June 2020 was conducted in PubMed. Patients and intervention domains were used to build up the searching formula. A study was eligible for inclusion if it was an original study of patients with ACS and it examined the utilization of statin. The risk of bias was assessed using Axis and NOS checklist. RESULTS: Among the 49 eligible studies, 38 were cohort studies while the others were cross-sectional studies. The utilization rate of statin at hospital admission ranged from 16% to 61% while 25% to 75% during the hospitalization. Of the total studies, 35 studies reported the statin rate at discharge ranging from 58% to 99%. Almost all studies revealed the reduction of statin utilization rate along the follow-up period. The number of statins prescribed was found to be lower among female and elderly patients. CONCLUSION: Despite the established benefits of statin among patients with ACS, our study revealed that statin was underutilized for secondary prevention after ACS. To improve patients’ clinical outcomes with ACS, efforts should be made to increase optimal treatment and compliance with a statin.

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“… 1 The 2013 Chinese expert consensus also emphasized that regardless of the baseline cholesterol levels, all patients with ACS events should immediately initiate and maintain intensive statin therapy long-term after discharge. 2 , 3 Based on the results of large-scale clinical trials, early intensive statin therapy has been recommended for patients with recent ACS events. Both epidemiological and interventional clinical trials have shown a strong association between elevated LDL-C level and cardiovascular events.…”

Section: Introductionmentioning

confidence: 99%

Uncontrolled hyperlipidemia in Chinese patients who experienced acute coronary syndrome: an observational study

Jiang

Zhou

et al. 2018

TCRM

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ObjectiveDespite current standard of care, the overall lipid goal attainment rate for hyperlipidemia patients, especially those who have experienced acute coronary syndrome (ACS), is suboptimal, which predisposes them to a higher residual risk of atherothrombotic events. This study aimed to describe characteristics of Chinese patients who recently experienced an ACS event and were on lipid-lowering treatment, yet failing to reach targeted goal.MethodsA multicenter, cross-sectional study was conducted to recruit 2,034 Chinese patients who experienced an ACS (ST segment elevation myocardial infarction [STEMI], non-STEMI, or unstable angina) event within the past 4–40 weeks and were on statin treatment (>2 weeks) from March 2015 to December 2016. All eligible patients underwent a fasting lipid test after enrollment and data on medical history were collected.ResultsThe mean age of 1,994 eligible patients was 61.0±9.84 years. Among them, 1,493 (74.9%) patients received intensive statin therapy (defined as atorvastatin 40 or 80 mg, or rosuvastatin 20 mg per protocol) and 499 (25.0%) patients were on maximum tolerated dose statin. Of the 1,994 eligible subjects, 1,273 (63.8%) patients did not achieve the lipid goal at the time of enrollment. Among the not-at-goal patients, 910 (71.5%) received intensive statin therapy; the majority (73.4%) of them were male; the mean age was 61.2±10.1 years old; 699 (54.9%) patients had a history of hypertension; 25.3% had diabetes mellitus; and 29.5% were current smokers. The mean low-density lipoprotein-cholesterol (LDL-C), non-high-density lipoprotein-cholesterol (non-HDL-C), and ApoB levels at enrollment of this group of patients were 2.460±0.7139 mmol/L, 3.094±0.8861 mmol/L, and 0.840±0.3015 g/L, respectively.ConclusionThe study result demonstrates that overall more than half of the patients who recently (4–40 weeks) experienced ACS who were treated did not reach the guideline-recommended LDL-C and non-HDL-C goal. These results highlight the potential necessity for a new drug beyond statins to further reduce disease burden in the future.

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Predictors of Nonuse of a High‐Potency Statin After an Acute Coronary Syndrome: Insights From the Stabilization of Plaques Using Darapladib‐Thrombolysis in Myocardial Infarction 52 (SOLID‐TIMI 52) Trial

Cited by 8 publications

References 24 publications

Statin Utilization Patterns and Outcomes for Patients with Acute Coronary Syndrome During and Following Inpatient Admissions

Statin Utilization Patterns and Outcomes for Patients with Acute Coronary Syndrome During and Following Inpatient Admissions

Statin Utilization among Patients with Acute Coronary Syndrome: Systematic Review

Uncontrolled hyperlipidemia in Chinese patients who experienced acute coronary syndrome: an observational study

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