Trends in Use of High-Intensity Statin Therapy After Myocardial Infarction, 2011 to 2014.

Academic Article

Abstract

  • BACKGROUND: Data prior to 2011 suggest that a low percentage of patients hospitalized for acute coronary syndromes filled high-intensity statin prescriptions upon discharge. Black-box warnings, generic availability of atorvastatin, and updated guidelines may have resulted in a change in high-intensity statin use. OBJECTIVES: The aim of this study was to examine trends and predictors of high-intensity statin use following hospital discharge for myocardial infarction (MI) between 2011 and 2014. METHODS: Secular trends in high-intensity statin use following hospital discharge for MI were analyzed among patients 19 to 64 years of age with commercial health insurance in the MarketScan database (n = 42,893) and 66 to 75 years of age with U.S. government health insurance through Medicare (n = 75,096). Patients filling statin prescriptions within 30 days of discharge were included. High-intensity statins included atorvastatin 40 or 80 mg and rosuvastatin 20 or 40 mg. RESULTS: The percentage of beneficiaries whose first statin prescriptions filled following hospital discharge for MI were for high-intensity doses increased from 33.5% in January through March 2011 to 71.7% in October through November 2014 in MarketScan and from 24.8% to 57.5% in Medicare. Increases in high-intensity statin use following hospital discharge occurred over this period among patients initiating treatment (30.6% to 72.0% in MarketScan and 21.1% to 58.8% in Medicare) and those taking low- or moderate-intensity statins prior to hospitalization (from 27.8% to 62.3% in MarketScan and from 12.6% to 45.1% in Medicare). In 2014, factors associated with filling high-intensity statin prescriptions included male sex, filling beta-blocker and antiplatelet agent prescriptions, and attending cardiac rehabilitation within 30 days following discharge. CONCLUSIONS: The use of high-intensity statins following hospitalization for MI increased progressively from 2011 through 2014.
  • Keywords

  • coronary artery disease, drug use, hydroxymethylglutaryl-CoA reductase inhibitors, secondary prevention, Aged, Atorvastatin, Dose-Response Relationship, Drug, Drug Prescriptions, Follow-Up Studies, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Myocardial Infarction, Patient Discharge, Retrospective Studies, Time Factors, Treatment Outcome
  • Digital Object Identifier (doi)

    Authorlist

  • Rosenson RS; Farkouh ME; Mefford M; Bittner V; Brown TM; Taylor B; Monda KL; Zhao H; Dai Y; Muntner P
  • Start Page

  • 2696
  • End Page

  • 2706
  • Volume

  • 69
  • Issue

  • 22