Cardiology
Original Research
Temporal Trends in the Use of High-Dose Potent Statins following Acute Coronary Syndrome in IsraelElis A.a, g · Pereg D.b, g · Dicker D.c, g · Gevrielov-Yusim N.d · Goldenberg I.e, g · Matetzky S.f, g · Kopel E.g · Klempfner R.eaDepartment of Medicine, Beilinson Hospital, Rabin Medical Center, Petach Tikva, bDivision of Cardiology, Meir Medical Center, Kfar Saba, cDepartment of Medicine, Hashron Hospital, Rabin Medical Center, Petach Tikva, dNeufeld Cardiac Research Institute, eCardiac Rehabilitation Institute and fLeviev Heart Center, Sheba Medical Center, Tel Hashomer, and gSackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
|
|
Log in to MyKarger to check if you already have access to this content.
KAB
Buy a Karger Article Bundle (KAB) and profit from a discount!
If you would like to redeem your KAB credit, please log in.
Save over 20% compared to the individual article price.
Article / Publication Details
Received: October 09, 2013
Accepted: January 03, 2014
Published online: May 24, 2014
Issue release date: June 2014
Number of Print Pages: 7
Number of Figures: 2
Number of Tables: 2
ISSN: 0008-6312 (Print)
eISSN: 1421-9751 (Online)
For additional information: https://www.karger.com/CRD
Abstract
Objectives: This study aimed to evaluate factors associated with the prescription of high-dose potent statin (HDPS) therapy following hospitalization for acute coronary events. Study Design: Sub-analysis was made using the data of 3,525 patients enrolled in the 2008 and 2010 Acute Coronary Syndrome Israeli Surveys (ACSIS). Methods: Analyses were carried out to identify demographic and clinical factors associated with the prescription of HDPS therapy (atorvastatin 40-80 mg/day or rosuvastatin 20-40 mg/day) at discharge compared with the prescription of lower-dose statins. Results: Among the study patients, 1,387 (39%) were discharged on HDPS, 1,860 (53%) with lower-dose statin regimens and 278 (8%) with no recommendation for statin therapy. Multivariate logistic regression analysis showed that pre-admission usage of HDPS and participation in the more recent (2010) ACSIS survey were independently associated with a higher likelihood of HDPS prescription at discharge from the index event (odds ratio, OR, 21.07, p < 0.001, and 5.61, p < 0.001, respectively), whereas factors independently associated with a lack of HDPS prescription included age >75 years (OR 0.76, p = 0.03), low-density lipoprotein-cholesterol levels <100 mg/dl on admission (OR 0.67, p < 0.001) and a history of heart failure prior to the index hospitalization (OR 0.54, p = 0.0018). The 30-day compliance with the HDPS regimen was 98%. Conclusions: The findings show increased use of HDPS therapy in acute coronary syndrome (ACS) patients, although this mode of medical therapy is still underutilized in the important subset of high-risk ACS patients.
© 2014 S. Karger AG, Basel
Related Articles:
References
- Anderson JL, Adams CD, Antman EM, et al: ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-Elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 2002 guidelines for the management of patients with unstable angina/non-ST-elevation myocardial infarction). J Am Coll Cardiol 2007;50:e1-e157.
- Reiner Z, Catapano AL, De Backer G, et al: ESC/EAS Guidelines for the management of dyslipidaemias: the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Eur Heart J 2011;32:1769-1818.
- Waters DD, Ku I: Early statin therapy in acute coronary syndromes: the successful cycle of evidence, guidelines, and implementation. J Am Coll Cardiol 2009;54:1434-1437.
- Fonarow GC: In-hospital initiation of statin therapy in acute coronary syndromes: maximizing the early and long-term benefits. Chest 2005;128:3641-3651.
- Behar S, Battler A, Porath A, Leor J, Grossman E, Hasin Y, Israel Heart and Internal Medicine Societies: A prospective national survey of management and clinical outcome of acute myocardial infarction in Israel, 2000. Isr Med Assoc J 2003;5:249-254.
- Schwartz GG, Olsson AG, Ezekowitz MD, et al: Effects of atorvastatin on early recurrent ischemic events in acute coronary syndromes: the MIRACL study: a randomized controlled trial. JAMA 2001;285:1711-1718.
- Ray KK, Cannon CP, McCabe CH, Cairns R, Tonkin AM, Sacks FM, Jackson G, Braunwald E, PROVE IT-TIMI 22 Investigators: Early and late benefits of highdose atorvastatin in patients with acute coronary syndromes: results from the PROVE IT-TIMI 22 trial. J Am Coll Cardiol 2005;46:1405-1410.
- Shiu JR, Pearson GJ, Charrois TL, Gyenes G, Koshman SL: Frequency of intensive statin therapy in patients with acute coronary syndrome admitted to a tertiary care center. Am J Cardiol 2012;109:1-5.
- Melloni C, Shah BR, Ou FS, Roe MT, Smith SC Jr, Pollack CV Jr, Ohman M, Gibler WB, Peterson ED, Alexander KP: Lipid-lowering intensification and low-density lipoprotein cholesterol achievement from hospital admission to 1-year follow-up after an acute coronary syndrome event: results from the Medications Applied and Sustained over Time (MAINTAIN) registry. Am Heart J 2010;160:1121-1129.
- Rittger H, Schnupp S, Sinha AM, Breithardt OA, Schmidt M, Zimmermann S, Mahnkopf C, Brachmann J, Rieber J: Predictors of treatment in acute coronary syndromes in the elderly: impact on decision making and clinical outcome after interventional versus conservative treatment. Catheter Cardiovasc Interv 2012;80:735-743.
- Lee HY, Cooke CE, Robertson TA: Use of secondary prevention drug therapy in patients with acute coronary syndrome after hospital discharge. J Manag Care Pharm 2008;14:271-280.
- Parikh S, Shrank WH, Mogun H, Choudhry NK: Statin utilization in nursing home patients after cardiac hospitalization. J Gen Intern Med 2010;25:1293-1299.
- Olsson AG, Schwartz GG, Szarek M, Luo D, Jamieson MJ: Effects of high-dose atorvastatin in patients ≥65 years of age with acute coronary syndrome (from the Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering [MIRACL] study). Am J Cardiol 2007;99:632-635.
- Zhang S, Zhang L, Sun A, Jiang H, Qian J, Ge J: Efficacy of statin therapy in chronic systolic cardiac insufficiency: a meta-analysis. Eur J Intern Med 2011;22:478-484.
- Sankaranarayanan R, Maini S, James MA, Burtchaell S, Chatterjee AK: Do statins improve heart failure outcome in post-myocardial infarction patients with moderate to severe left ventricular dysfunction? Congest Heart Fail 2010;16:181-186.
- Erbs S, Beck EB, Linke A, Adams V, Gielen S, Kränkel N, Möbius-Winkler S, Höllriegel R, Thiele H, Hambrecht R, Schuler G: High-dose rosuvastatin in chronic heart failure promotes vasculogenesis, corrects endothelial function, and improves cardiac remodeling - results from a randomized, double-blind, and placebo-controlled study. Int J Cardiol 2011;146:56-63.
- Benner JS, Glynn RJ, Mogun H, Neumann PJ, Weinstein MC, Avorn J: Long-term persistence in use of statin therapy in elderly patients. JAMA 2002;288:455-461.
- Benner JS, Pollack MF, Smith TW, Bullano MF, Willey VJ, Williams SA: Association between short-term effectiveness of statins and long-term adherence to lipid-lowering therapy. Am J Health Syst Pharm 2005;62:1468-1475.
- Simons LA, Ortiz M, Calcino G: Long term persistence with statin therapy-experience in Australia 2006-2010. Aust Fam Physician 2011;40:319-322.
Article / Publication Details
Received: October 09, 2013
Accepted: January 03, 2014
Published online: May 24, 2014
Issue release date: June 2014
Number of Print Pages: 7
Number of Figures: 2
Number of Tables: 2
ISSN: 0008-6312 (Print)
eISSN: 1421-9751 (Online)
For additional information: https://www.karger.com/CRD
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

Get Permission