High-Intensity Statin Therapy Underutilized After Heart Attack

Dr. Robert S. Rosenson, MD Professor, Cardiology Icahn School of Medicine at Mount Sinai Cardiovascular Institute New York, New York 10029MedicalResearch.com Interview with:
Dr. Robert S. Rosenson, MD

Professor, Cardiology
Icahn School of Medicine at Mount Sinai
Cardiovascular Institute
New York, New York 10029

Medical Research: What is the background for this study? What are the main findings?

Dr. Rosenson: High intensity statin therapy is evidence-based and guideline directed for patients with acute coronary syndromes.  In a 5 percent random sample of Medicare patients, we investigated the utilization of high vs low-moderate dosage statin in older adjusts who were admitted with an acute myocardial infarction of severe myocardial ischemia requiring hospitalization for a revascularization procedure (PCI or CABG).

We report that only 27 percent of hospitalized patients received high-intensity statin therapy based on their first outpatient fill for a statin medication.  The most important determinant for the utilization of statin therapy is the dosage of the statin previously prescribed as an outpatient.  When patients were started on a high-intensity statin, the continued use diminished in the ensuing year

Medical Research: What should clinicians and patients take away from your report?

Dr. Rosenson: Evidence-based guidelines recommend in hospital initiation of high-intensity statin for patients with acute coronary syndromes, and this therapy should be continued long-term.  It is important to understand that we do not treat these patients to a LDL cholesterol target as statins have other salutary effects that extend beyond cholesterol lowering.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Rosenson: We have plans to evaluate treatment patterns and the impact on cardiovascular events.

Citation:

Underutilization of High-Intensity Statin Therapy After Hospitalization for Coronary Heart Disease

Robert S. Rosenson, MD  , Shia T. Kent, PhD Todd M. Brown, MD Michael E. Farkouh, MD Emily B. Levitan, PhD, Huifeng Yun, MD, PhD Pradeep Sharma, MS Monika M. Safford, MD Meredith Kilgore, PhD Paul Muntner, PhD Vera Bittner, MD