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High-intensity statin use increased in patients with MI
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High-intensity statin use after hospitalization for MI significantly increased regardless of age from 2011 to 2014, according to recent findings.
“Analyses of registries and insurance claims databases have documented that between 20% and 40% of patients with ACS fill prescriptions for high-intensity statins following hospital discharge. However, these studies were conducted among patients having CHD events through 2011, with few more contemporary data being published,” Robert S. Rosenson, MD, director of cardiometabolic disorders and professor of medicine at the Icahn School of Medicine at Mount Sinai, and colleagues wrote. “Several events have occurred over the past several years that may have changed the use of high-intensity statins among patients with ACS.”
Rosenson and colleagues analyzed statin usage for participants using commercial health insurance aged 19 to 64 years (n = 42,893) in the MarketScan database and participants with Medicare aged 66 to 75 years (n = 75,096). Those who filled prescriptions within 30 days of discharge for MI were included in the study; high-intensity statin usage was defined as atorvastatin 40 mg or 80 mg or rosuvastatin (Crestor, AstraZeneca) 20 mg or 40 mg.
From January to March 2011, 33.5% of participants from the MarketScan database filled a prescription after hospitalization for MI within 30 days for a high-intensity statin vs. 71.7% from October to November 2014. For Medicare beneficiaries, the rate increased from 24.8% to 57.5%.
In patients initiating treatment, high-intensity statin use increased from 30.6% to 72% in MarketScan participants and from 21.1% to 58.8% in Medicare participants. In participants taking low- or moderate-intensity statins before hospitalization, use of high-intensity statins increased after hospitalization, from 27.8% to 62.3% in MarketScan participants and from 12.6% to 45.1% in Medicare participants.
In 2104, male participants or those filling prescriptions for beta-blockers or antiplatelet agents or attending cardiac rehabilitation after their MI were more likely to initiate high-intensity statins or to titrate from low- or moderate-intensity to high-intensity. Those with more medications, as well as white patients, were less likely to start high-intensity statins after MI.
“The percentage of U.S. adults filling high-intensity statin prescriptions following hospital discharge for MI increased substantially between 2011 and 2014,” the researchers wrote. “This trend was present among younger commercially insured U.S. adults and older U.S. adults with government health insurance. Despite this favorable trend, a substantial percentage of patients filled low- or moderate-intensity statin prescriptions following hospital discharge for MI in 2014. The present study highlights the need to continue efforts to increase high-intensity statin use following hospital discharge for MI.” – by Cassie Homer
Disclosure: Rosenson reports receiving grant support from Akcea, Amgen, AstraZeneca, Eli Lilly, Esperion, The Medicines Company and Sanofi; serving on advisory boards for Amgen, Eli Lilly, Regeneron and Sanofi; receiving honoraria from Akcea and Kowa; and receiving royalties from UpToDate. Please see the full study for the other researchers’ relevant financial disclosures.
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