Patterns of statin non-prescription in patients with established coronary artery disease: A report from a contemporary multicenter Japanese PCI registry

PLoS One. 2017 Aug 17;12(8):e0182687. doi: 10.1371/journal.pone.0182687. eCollection 2017.

Abstract

Statin therapy is regarded as an effective medication to reduce cardiovascular events in patients at higher risk for future incidence of coronary artery disease. However, very few studies have been conducted to examine its implementation in non-Western real-world practice. In this study, we sought to describe statin prescription patterns in relation to patient characteristics in a Japanese multicenter percutaneous coronary intervention (PCI) registry as a foundation for quality improvement. We studied 15,024 patients that were prospectively enrolled in the Japan Cardiovascular Database-Keio interhospital Cardiovascular Study Registry from January 2009 to August 2014. The overall discharge statin non-prescription rate was 15.2%, without significant interhospital (MOR = 1.01) or annual differences (MOR = 1.13) observed. Hierarchical multivariable logistic regression analysis accounting for regional differences revealed that the presence of chronic kidney disease was associated with higher rates of statin non-prescription (OR 1.87, 95% confidence interval, 1.69-2.08, p value <0.001), and higher age (per 1-year increase) showed a trend for prescription of low-intensity statin (OR 1.00, 95% confidence interval, 1.00-1.01, p value = 0.045) within the subset of PCI patients (N = 4,853) enrolled after the year 2011. Our study indicates that patients with chronic kidney disease and elderlies may be the primary targets for maximizing the beneficial effect of statin therapy in post PCI patients.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Coronary Artery Disease / drug therapy*
  • Coronary Artery Disease / epidemiology
  • Drug Prescriptions / statistics & numerical data*
  • Female
  • Hospitals / statistics & numerical data
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage*
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Japan
  • Male
  • Middle Aged
  • Registries / statistics & numerical data
  • Renal Insufficiency, Chronic / epidemiology

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors

Grants and funding

The present study was funded by the Grants-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (KAKENHI; No. 25460630 and 25460777, https://kaken.nii.ac.jp/ja/index/). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.