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Trends in high intensity statin use among secondary prevention patients 76 years and older
Michele Wood1, Thomas Delate2, Sheila L Stadler3
1Clinical Pharmacy Specialist. Pharmacy Department, Kaiser Permanente Colorado. Aurora, CO (United States) mdw71943@gmail.com.
Insights
High-intensity statin therapy (HIST) use significantly increased in older adults (≥76 years) with atherosclerotic cardiovascular disease (ASCVD) from 2007 to 2016. This trend highlights a growing adoption of intensive statin treatment in this population.
Area of Science:
- Cardiology
- Geriatrics
- Pharmacotherapy
Background:
- High-intensity statin therapy (HIST) is crucial for managing atherosclerotic cardiovascular disease (ASCVD).
- Limited data exists on HIST utilization in elderly ASCVD patients.
- Understanding trends in older adults is vital for optimizing cardiovascular care.
Purpose of the Study:
- To analyze temporal trends in statin intensity among older adults with ASCVD.
- To evaluate changes in HIST prescription patterns over a decade (2007-2016).
Main Methods:
- Cross-sequential study design within an integrated healthcare system.
- Inclusion criteria: patients aged 76+ with validated coronary ASCVD.
- Data extracted from administrative databases, assessing statin intensity biannually.
Main Results:
- 5,453 patients included; 38.9% received HIST, 61.1% Non-HIST.
- HIST use rose from 14.5% to 41.3% (p<0.001) between 2007 and 2016.
- Moderate and low-intensity statin use decreased significantly in the same period.
Conclusions:
- A substantial increase in HIST use was observed in elderly ASCVD patients (≥76 years) from 2007-2016.
- This upward trend in high-intensity statin therapy was consistent across both genders.
- Further research is recommended to compare cardiac outcomes between HIST and Non-HIST in this demographic.
Background:
High intensity statin therapy (HIST) is the gold standard therapy for decreasing the risk of recurrent atherosclerotic cardiovascular disease (ASCVD); however, little is known about the use of HIST in older adults with ASCVD.
Objectives:
The aim of this cross-sequential study was to determine trends in statin intensity in older adults over a 10-year timeframe.
Methods:
The study was conducted in an integrated healthcare delivery system. Patients were 76 years or older with validated coronary ASCVD. Data were collected from administrative databases. Statin intensity level was assessed in eligible patients on January 1st and July 1st from January 1, 2007 to December 31, 2016.
Results:
Overall, a total of 5,453 patients were included with 2,119 (38.9%) and 3,334 (61.1%) categorized as HIST and Non-HIST, respectively. Included patients had a mean age of 79.8 years and were primarily male and white and had a cardiac intervention. The rate of HIST use increased from 14.5% to 41.3% over the study period (p<0.001 for trend). Conversely, the rates of moderate and low intensity statin use decreased from 61.8% and 9.8% to 41.2% and 4.8%, respectively (both p<0.001 for trend). Similar trends were identified for females and males.
Conclusions:
The percentage of patients with ASCVD 76 years and older who received HIST substantially increased from 2007 to 2016. This trend was identified in both females and males. Future comparative effectiveness research should be conducted in this patient population to examine cardiac-related outcomes with HIST and Non-HIST use.
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