21 Aug Younger Patients with Atherosclerotic Heart Disease Less Likely To Receive Aspirin or Statins
MedicalResearch.com Interview with:
Dhruv Mahtta, DO, MBA
Cardiovascular Disease Fellow
Baylor College of Medicine
Senior & Corresponding Author
Salim S. Virani, MD, PhD, FACC, FAHA, FASPC
Professor, Section of Cardiovascular Research
Director, Cardiology Fellowship Training Program
Baylor College of Medicine
Staff Cardiologist, Michael E. DeBakey Veterans Affairs Medical Center
Co-Director, VA Advanced Fellowship in Health Services Research & Development
Michael E. DeBakey VA Medical Center, Houston, TX
MedicalResearch.com: What is the background for this study?
Response: The incidence of atherosclerotic cardiovascular disease among young patients has been on the rise. These patients with premature and extremely premature atherosclerotic cardiovascular disease experience similar rates of mortality compared to older adults. Additionally, these young patients have a greater accrued rate of life-time morbidity. Therefore, secondary prevention measures such as use of guideline concordant statin therapy and aspirin therapy are paramount in this population.
MedicalResearch.com: What are the main findings?
Response: In our cross-sectional analysis, we demonstrated that young patients with premature and extremely premature atherosclerotic cardiovascular disease had a significantly lower likelihood of aspirin use, statin use, and statin adherence when compared to older adults with nonpremature atherosclerotic cardiovascular disease.
MedicalResearch.com: What should readers take away from your report?
Response: Patients who are diagnosed with atherosclerotic cardiovascular disease at a young age have a greater accrued life-time morbidity, loss of productivity due to their underlying disease, and are likely to derive the highest benefit from aspirin and statin therapy. However, given the prevailing perceptions regarding the relationship between older age and risk of atherosclerotic cardiovascular disease, young patients with atherosclerotic cardiovascular disease are less likely to receive as aggressive guideline concordant medical therapy as compared to older adults. Furthermore, adherence with such therapies remains significantly lower among the younger patients as compared to their older counterparts.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Future qualitative research is needed to understand reasons behind less aggressive medical therapy and adherence with such therapy among the younger population. Additionally, research efforts are needed to evaluate the impact of various evidence-based strategies such as clinician education and motivational interviewing on increasing prescription rates and adherence among the young patients with atherosclerotic cardiovascular disease.
Dr. Dhruv Mahtta reports no disclosures.
Dr. Salim S. Virani reports receiving grants from the US Department of Veterans Affairs (VA) during the conduct of the study and grants from the World Heart Federation and the Jooma and Tahir Family and honorarium from the American College of Cardiology in his role as the Associate Editor for Innovations acc.org
Mahtta D, Ramsey DJ, Al Rifai M, et al. Evaluation of Aspirin and Statin Therapy Use and Adherence in Patients With Premature Atherosclerotic Cardiovascular Disease. JAMA Netw Open. 2020;3(8):e2011051. doi:10.1001/jamanetworkopen.2020.11051
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