Abstract 326: High Potency Statins Underutilized in Patients with Atherosclerotic Cardiovascular Disease (ASCVD)
Introduction: The 2013 AHA/ACC Cholesterol Guidelines advocate that all patients with ASCVD receive high potency statins (HPS). However, little is known about current patterns of HPS use. Therefore, we determined patterns of HPS in ASCVD patients in a large, contemporary managed-care database.
Methods: Patients ≥18 years old with documented ASCVD with ≥1 LDL-C test from Jan 2004 to Dec 2012 were identified in the Optum Insight database. HPS use was defined as treatment with atorvastatin (40or 80 mg), rosuvastatin (20or 40mg), or simvastatin 80mg. Patients who received other lipid lowering therapies (LLTs) and those who were untreated were identified. We calculated monthly average LDL-C measures and the proportion of patients that achieve LDL-C goals of <70mg/dL and 100mg/dL
Results: The number of eligible patients ranged from 45, 101 (2004) to 40,846 (2012). Overall, ASCVD patients treated with HPS increased from 13% (2004) to 26% (2012). Among LLT-treated, the percentage of patients that received HPS increased from 20% (2004) to 38% (2012). HPS patients had a slightly lower average LDL-C than non-HPS LLT patients in January 2004 (101.9 ± 33.6 mg/dL versus 104.1 ± 31.8. mg/dL) but the difference increased substantially by December 2012 (85.6 ± 29.3mg/dL versus 94.0 mg/dL ± 32.2 mg/dL). HPS patients were also more likely to attain an LDL goal of <70 mg/dL relative to non-HPS LLT patients and untreated patients. A similar pattern was observed when a goal of LDL<100 mg/dL was used.
Conclusions: Using a large managed-care dataset of patients with ASCVD, we found that over the past decade HPS use has increased. However, despite the growing use of high-potency statins for this high-risk population, less than 26% of ASCVD patients were prescribed high potency statins by 2012. Further research and interventions are needed to address substantial gaps in care and how best to implement new, national recommendations in order to improve patient outcomes.
Author Disclosures: F. Rodriguez: None. T. Olufade: A. Employment; Significant; Merck. K. Heithoff: A. Employment; Significant; Merck. P. Navaratnam: C. Other Research Support; Significant; Merck. H. Friedman: C. Other Research Support; Significant; Merck. J. Foody: G. Consultant/Advisory Board; Modest; Merck, Pfizer, Sanofi- Aventis.
- © 2014 by American Heart Association, Inc.