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Patterns of statin use and cholesterol goal attainment in a high-risk cardiovascular population: A retrospective study of primary care electronic medical records

Objective To describe real-life patterns of statin use and cholesterol goal attainment in a retrospective cohort of patients with high cardiovascular risk. Methods Retrospective cohort study of 21,636 individuals, 18.34% women, mean age 63.30 years (standard deviation 6.29). New statin users aged 35 to 74 years at high cardiovascular risk and with no previous cardiovascular disease in primary care electronic medical records (2006-2011). Patterns of statin use were based on statin type, potency, and 1-year statin switches. Outcomes Relative mean reductions over 1 year and probability of goal attainment (<3.3 mmol/L). Natural patterns of statin use were identified using multiple correspondence analysis; general linear and logistic models were used to estimate low-density lipoprotein cholesterol (LDL-C) reductions and goal attainment probability. Results Three patterns of statin use were defined: low (3.82% of the population), moderate (71.94%), and high intensity (24.24%). After 1 year, potency decreased 42.74%, 64.16%, and 50.94%, respectively, and 37.41%, 29.47%, and 30.16% of the population stopped taking statins in low, moderate, and high patterns, respectively. Relative reductions in LDL-C: low intensity, 15.7% (95% confidence interval [CI]: -22.96 to 54.36); moderate intensity, 29.72% (95% CI: 29.12-30.32); and high intensity, 24.20% (95% CI: -8.08 to 40.32). There was a direct relationship between higher intensity patterns and greater probability of goal attainment. Conclusions Three real-life patterns of statin use were identified. Lipid management strategies in primary care should focus on improving adherence to treatment. People starting at low potency should switch to a moderate pattern; more intensive therapies should be considered in who require a larger LDL-C reduction to reach therapeutic targets, patients with good treatment adherence who do not achieve the goal with a moderate pattern of therapy or patients at very high risk

© Journal of Clinical Lipidology, 2016, vol. 10, núm. 1, p. 134-142

Elsevier

Author: García Gil, María del Mar
Blanch, Jordi
Comas Cufí, Marc
Daunis i Estadella, Josep
Bolíbar, Bonaventura
Martí Lluch, Ruth
Ponjoan, Anna
Alves Cabratosa, Lia
Ramos Blanes, Rafel
Date: 2016
Abstract: Objective To describe real-life patterns of statin use and cholesterol goal attainment in a retrospective cohort of patients with high cardiovascular risk. Methods Retrospective cohort study of 21,636 individuals, 18.34% women, mean age 63.30 years (standard deviation 6.29). New statin users aged 35 to 74 years at high cardiovascular risk and with no previous cardiovascular disease in primary care electronic medical records (2006-2011). Patterns of statin use were based on statin type, potency, and 1-year statin switches. Outcomes Relative mean reductions over 1 year and probability of goal attainment (<3.3 mmol/L). Natural patterns of statin use were identified using multiple correspondence analysis; general linear and logistic models were used to estimate low-density lipoprotein cholesterol (LDL-C) reductions and goal attainment probability. Results Three patterns of statin use were defined: low (3.82% of the population), moderate (71.94%), and high intensity (24.24%). After 1 year, potency decreased 42.74%, 64.16%, and 50.94%, respectively, and 37.41%, 29.47%, and 30.16% of the population stopped taking statins in low, moderate, and high patterns, respectively. Relative reductions in LDL-C: low intensity, 15.7% (95% confidence interval [CI]: -22.96 to 54.36); moderate intensity, 29.72% (95% CI: 29.12-30.32); and high intensity, 24.20% (95% CI: -8.08 to 40.32). There was a direct relationship between higher intensity patterns and greater probability of goal attainment. Conclusions Three real-life patterns of statin use were identified. Lipid management strategies in primary care should focus on improving adherence to treatment. People starting at low potency should switch to a moderate pattern; more intensive therapies should be considered in who require a larger LDL-C reduction to reach therapeutic targets, patients with good treatment adherence who do not achieve the goal with a moderate pattern of therapy or patients at very high risk
Format: application/pdf
ISSN: 1933-2874
Document access: http://hdl.handle.net/10256/12214
Language: eng
Publisher: Elsevier
Collection: Reproducció digital del document publicat a: http://dx.doi.org/10.1016/j.jacl.2015.10.007
Articles publicats (D-IMA)
Is part of: © Journal of Clinical Lipidology, 2016, vol. 10, núm. 1, p. 134-142
Rights: Attribution-NonCommercial-NoDerivs 3.0 Spain
Rights URI: http://creativecommons.org/licenses/by-nc-nd/3.0/es/
Subject: Cardiologia
Cardiology
Sistema cardiovascular -- Malalties
Cardiovascular system -- Diseases
Title: Patterns of statin use and cholesterol goal attainment in a high-risk cardiovascular population: A retrospective study of primary care electronic medical records
Type: info:eu-repo/semantics/article
Repository: DUGiDocs

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