20 Jan High-Intensity Statin Therapy Underutilized After Heart Attack
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.
Robert S. Rosenson, , Shia T. Kent, Todd M. Brown, Michael E. Farkouh, Emily B. Levitan, †, Huifeng Yun, Pradeep Sharma, Monika M. Safford, Meredith Kilgore, Paul Muntner, Vera Bittner,