Among Patients With Atherosclerotic Cardiovascular Disease Who Are Eligible For High-Intensity Statins, Most Are Not Using Them

Patients with atherosclerotic cardiovascular disease (ASCVD) who are being treated for the disease are underutilizing high-intensity statins, according to a study published in August 2023.

A team of researchers evaluated the use of statins and other lipid-lowering therapy and changes in low-density lipoprotein cholesterol among patients with ASCVD. In total, 322,153 patients (58.8% men, 81.8% women) with ASCVD were included in the analysis. Data was obtained from Cerner Real-World Data, which is an electronic record-derived data set from 92 United States health systems. Lipid-lowering therapy and low-density lipoprotein cholesterol levels at the first outpatient visit and 1-year follow-up were evaluated.

Of the total, 76.1% of patients were on statins, while only 39.4% were utilizing high-intensity statins. Further, the researchers found that men were more likely to receive high-intensity statins than women, and older adults had lower odds of statin use. Patients diagnosed with peripheral artery disease and cerebrovascular disease had lower odds of using high-intensity statins than patients with coronary artery disease.

Additionally, most patients had elevated low-density lipoprotein cholesterol levels. This included 59.8% of those on low-moderate-intensity statins and 76.1% not using statins. Among patients on no statin or low-to-moderate-intensity statin at baseline, 14.8% and 13.4%, respectively, were on high-intensity statins at 1 year.

“Among patients with ASCVD in routine care, high-intensity statins are underutilized, and uptitration and use of nonstatin therapy are uncommon,” the researchers concluded. “Women, older adults, and individuals with noncardiac ASCVD are particularly undertreated. Concerted efforts are needed to address therapeutic inertia for lipid management in patients with ASCVD.”

Reference:
Navar AM, Kolkailah AA, Gupta A, et al. Gaps in Guideline-Based Lipid-Lowering Therapy for Secondary Prevention in the United States: A Retrospective Cohort Study of 322 153 Patients. Circ Cardiovasc Qual Outcomes. 2023;16(8):533-543. doi:10.1161/CIRCOUTCOMES.122.009787