Prescription of statins after acute coronary syndrome; a single-centre observational study
Muhammad Muzaffar Mahmood1, Muhammad Jabran Nawaz2
1Department of Cardiology, Ittefaq Hospital, Lahore, Pakistan.
Insights
High-intensity statin (HIS) use after acute coronary syndrome (ACS) in Pakistan is suboptimal. While 48.2% of patients received HIS, medically treated individuals were significantly less likely to benefit from these crucial lipid-lowering therapies.
Area of Science:
- Cardiology
- Pharmacology
- Public Health
Background:
- Acute coronary syndrome (ACS) necessitates aggressive lipid management.
- High-intensity statins (HIS) are crucial for secondary prevention post-ACS.
- Data on HIS utilization in Pakistani ACS patients are scarce.
Purpose of the Study:
- To investigate the prescription patterns of high-intensity statins (HIS) in Pakistani patients following acute coronary syndrome (ACS).
- To identify factors associated with HIS prescription in this patient cohort.
Main Methods:
- Retrospective study of 411 patients admitted with ACS at Ittefaq Hospital, Lahore, from February 2019 to December 2019.
- Analysis of statin and HIS prescription rates based on treatment modality (Percutaneous Coronary Intervention, Coronary Artery Bypass Graft, medical management) and patient demographics.
- Statistical analysis to determine the association between patient characteristics and HIS prescription.
Main Results:
- Overall, 48.2% of ACS patients received HIS, with 10.9% receiving maximally dosed therapy.
- Patients undergoing Percutaneous Coronary Intervention (PCI) were significantly more likely to receive HIS (73.3%) compared to other groups.
- Older patients (>75 years), medically treated patients, and those with reduced LV systolic function were less likely to receive HIS (p <0.001).
Conclusions:
- A significant gap exists in the implementation of high-intensity statin guidelines for ACS patients in Pakistan.
- Medically treated ACS patients represent a key subgroup with underutilization of HIS.
- Further research and interventions are needed to optimize HIS prescribing practices post-ACS in this population.
Abstract:
There is limited information about the current use of high-intensity statins (HIS) after acute coronary syndrome (ACS) in Pakistani patients. We studied the prescription of HIS in patients admitted with ACS to Ittefaq Hospital, Lahore, Pakistan, from February 2019 to December 2019. Among the 411 patients, 221 (53.8%) patients underwent Percutaneous Coronary Intervention (PCI), 62 (15.1%) were referred for Coronary Artery Bypass Graft (CABG), and 128 (31.1%) were treated medically. Overall 408 (99.3%) patients were prescribed statins and 198 (48.2%) received HIS, with 45 (10.9%) patients receiving maximally allowed dose (Atorvastatin 80mg or Rosuvastatin 40mg). Patients treated with PCI were more likely to be prescribed HIS (73.3% vs 26.7%, p <0.001), while older patients (>75 years of age), those treated medically, and patients with severely reduced LV systolic function were significantly less likely to receive HIS (p <0.001). Our study, therefore, identifies a gap in implementation of guidelines for HIS use, particularly among the medically treated ACS patients.
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