Temporal changes in statin prescription and intensity at discharge and impact on outcomes in patients with newly diagnosed atherosclerotic cardiovascular disease—Real-world experience within a large integrated health care system: The IMPRES study

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作   者：

Jeffrey L. Anderson;  Kirk U. Knowlton;  Heidi T. May;  Tami L. Bair;  Shannon O. Armstrong;  Donald L. Lappé;  Joseph B. Muhlestein; 

作者机构：

Intermountain Heart Institute;  Medicines Company;  Intermountain Medical Center; 

关键词：

Adherence;  Prescription;  Secondary prevention;  Guideline;  Treatment gap;  Atherosclerotic cardiovascular disease (ASCVD);  Statin; 

期刊名称：

Journal of clinical lipidology

i s s n：

1933-2874

年卷期：

2018 年 12 卷 4 期

页   码：

1008-1018.e1

页   码：

摘   要：

BackgroundStatins are indicated for secondary atherosclerotic cardiovascular disease (ASCVD) prevention; however, multiple surveys have found treatment gaps in clinical application. ObjectiveTo determine trends over 15?years in the prevalence and impact of a statin prescription and dose intensity at discharge after a first ASCVD event. MethodsThe Intermountain Enterprise Data Warehouse was searched to identify all adults with a first encounter for ASCVD between January 1, 1999 and December 31, 2013, including coronary artery disease, cerebrovascular disease, and peripheral arterial disease, who survived the index event and were followed for ≥3?years or until death. Major adverse cardiovascular events (MACE) were assessed overall and in 5-year increments. ResultsA total of 62,070 patients met inclusion criteria. Mean age was 65.9?±?13.7?years, and most of them were male (64.7%). Increases in any statin (59.3% to 72.6% to 80.8%) and high-intensity prescription (3.1% to 14.2% to 28.1%) occurred over consecutive 5-year intervals and were greatest in coronary artery disease patients. Statin therapy was associated with a reduced risk of 3-year MACE (multivariable hazard ratio?=?0.75 [0.72, 0.