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Trends in High-Intensity Statin Therapy Use After MI
Study Questions:
Has the use of high-intensity dose statins increased over time among patients with a recent myocardial infarction (MI)?
Methods:
Data from commercial health insurance in the MarketScan database and from US government health insurance (Medicare) were used to examine trends in high-intensity statin use following hospital discharge for an MI between 2011 and 2014. Only patients filling a statin prescription within 30 days of discharge were included. High-intensity statins included atorvastatin 40 or 80 mg and rosuvastatin 20 or 40 mg.
Results:
A total of 42,893 patients from the commercial health insurance were between the ages of 19 and 64 years of age, while a total of 75,096 patients from the Medicare database were between 66 and 75 years of age. Comparing January–March of 2011 to October–November of 2014, the number of patients discharged following an MI, whose statin prescription was for a high-intensity dose increased from 33.5% to 71.7% in the MarketScan database and from 24.8% to 57.5% in the Medicare database. Increases in high-intensity dose statin therapy over time were observed for those who were statin naive and those who had been on moderate-dose statin prior to admission. In 2014, factors associated with filling high-intensity statin prescriptions included male sex, filling a beta-blocker and antiplatelet agent, and attending cardiac rehabilitation within 30 days following discharge.
Conclusions:
The authors concluded that utilization of high-intensity statins following hospitalization for MI increased progressively from 2011 through 2014.
Perspective:
These data demonstrate increased use of high-dose statin therapy consistent with current recommendations; however, it appears that factors related to filling such a prescription related to access to care. Further monitoring of these trends is warranted to understand which patients are not receiving appropriate therapies such as statin and why.
Keywords: Adrenergic beta-Antagonists, Cardiac Rehabilitation, Geriatrics, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Medicare, Myocardial Infarction, Patient Discharge, Platelet Aggregation Inhibitors, Prescription Drugs, Secondary Prevention
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