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High-Intensity Statin Use Among Patients With Atherosclerosis in the U.S.

Publication ,  Journal Article
Nelson, AJ; Haynes, K; Shambhu, S; Eapen, Z; Cziraky, MJ; Nanna, MG; Calvert, SB; Gallagher, K; Pagidipati, NJ; Granger, CB
Published in: J Am Coll Cardiol
May 10, 2022

BACKGROUND: Preventive therapy among patients with established atherosclerotic cardiovascular disease (ASCVD) is generally underused. Whether new guideline recommendations and a focus on implementation have improved the use of high-intensity statins is unknown. OBJECTIVES: This study sought to evaluate the patterns and predictors of statin use among patients with ASCVD. METHODS: In this retrospective cohort study, pharmacy and medical claims data from a commercial health plan were queried for patients with established ASCVD between January 31, 2018, and January 31, 2019. Statin use on an index date of January 31, 2019, was evaluated, as was 12-month adherence and discontinuation. Multivariable logistic regression was used to determine independent associations with statin use of varying intensities. RESULTS: Of the 601,934 patients with established ASCVD, 41.7% were female, and the mean age was 67.5 ± 13.3 years. Overall, 22.5% of the cohort were on a high-intensity statin, 27.6% were on a low- or moderate-intensity statin, and 49.9% were not on any statin. In multivariable analysis, younger patients, female patients, and those with higher Charlson comorbidity score were less likely to be prescribed any statin. Among statin users, female patients, older patients, and those with peripheral artery disease were less likely to be on a high-intensity formulation, whereas a cardiology encounter in the prior year increased the odds. The majority of high-intensity stain users achieved high levels of adherence. CONCLUSIONS: Substantial underuse of statins persists in a large, insured, and contemporary cohort of patients with ASCVD from the United States. In particular, concerning gaps in appropriate statin use remain among younger patients, women, and those with noncoronary ASCVD.

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Published In

J Am Coll Cardiol

DOI

EISSN

1558-3597

Publication Date

May 10, 2022

Volume

79

Issue

18

Start / End Page

1802 / 1813

Location

United States

Related Subject Headings

  • United States
  • Retrospective Studies
  • Peripheral Arterial Disease
  • Middle Aged
  • Male
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Humans
  • Female
  • Cardiovascular System & Hematology
  • Cardiovascular Diseases
 

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Nelson, A. J., Haynes, K., Shambhu, S., Eapen, Z., Cziraky, M. J., Nanna, M. G., … Granger, C. B. (2022). High-Intensity Statin Use Among Patients With Atherosclerosis in the U.S. J Am Coll Cardiol, 79(18), 1802–1813. https://doi.org/10.1016/j.jacc.2022.02.048
Nelson, Adam J., Kevin Haynes, Sonali Shambhu, Zubin Eapen, Mark J. Cziraky, Michael G. Nanna, Sara B. Calvert, Kerrin Gallagher, Neha J. Pagidipati, and Christopher B. Granger. “High-Intensity Statin Use Among Patients With Atherosclerosis in the U.S.J Am Coll Cardiol 79, no. 18 (May 10, 2022): 1802–13. https://doi.org/10.1016/j.jacc.2022.02.048.
Nelson AJ, Haynes K, Shambhu S, Eapen Z, Cziraky MJ, Nanna MG, et al. High-Intensity Statin Use Among Patients With Atherosclerosis in the U.S. J Am Coll Cardiol. 2022 May 10;79(18):1802–13.
Nelson, Adam J., et al. “High-Intensity Statin Use Among Patients With Atherosclerosis in the U.S.J Am Coll Cardiol, vol. 79, no. 18, May 2022, pp. 1802–13. Pubmed, doi:10.1016/j.jacc.2022.02.048.
Nelson AJ, Haynes K, Shambhu S, Eapen Z, Cziraky MJ, Nanna MG, Calvert SB, Gallagher K, Pagidipati NJ, Granger CB. High-Intensity Statin Use Among Patients With Atherosclerosis in the U.S. J Am Coll Cardiol. 2022 May 10;79(18):1802–1813.
Journal cover image

Published In

J Am Coll Cardiol

DOI

EISSN

1558-3597

Publication Date

May 10, 2022

Volume

79

Issue

18

Start / End Page

1802 / 1813

Location

United States

Related Subject Headings

  • United States
  • Retrospective Studies
  • Peripheral Arterial Disease
  • Middle Aged
  • Male
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Humans
  • Female
  • Cardiovascular System & Hematology
  • Cardiovascular Diseases