Trends in prescribing rate of statins at discharge and modifiable factors in patients with atherosclerotic cardiovascular disease

Intern Emerg Med. 2017 Dec;12(8):1121-1129. doi: 10.1007/s11739-017-1694-9. Epub 2017 Jun 8.

Abstract

Tremendous effort has been invested in reducing the prevalence of atherosclerotic cardiovascular disease (ASCVD) in China. Meanwhile, accumulating evidence has emerged to show the benefits of statins in the prevention of cardiovascular disease. The present study investigated the change trends of statins prescription at discharge among patients with ASCVD in recent years, differences across subtypes of ASCVD, and associated factors. The study included 51,972 patients with a discharge diagnosis of ASCVD who were hospitalized in West China Hospital from 2008 to 2014. Trends of statins prescription rates between subtypes of ASCVD were compared and potential influential factors were explored. The overall statins prescription rate in patients with ASCVD was 58.8%. Adjusted odds ratios (ORs) of increase in prescription rate per year were 1.15 (95% CI 1.13-1.17, p < 0.001), 1.14 (95% CI 1.10-1.17, p < 0.001), 1.19 (95% CI 1.16-1.23; p < 0.001), 1.14 (95% CI 1.09-1.19; p < 0.001), and 1.13 (95% CI 1.09-1.17; p < 0.001) for ASCVD, coronary artery disease, cerebrovascular disease, peripheral arterial disease (PAD), and polyvascular disease, respectively; no significant differences in trends were detected among ASCVD subtypes. However, statins prescription rates were persistently lower in cerebrovascular disease and PAD than the other two subtypes. Discharge departments, together with other physician-related and patient-related characteristics were associated with statins utilization. In conclusion, between 2008 and 2014, statins prescription rate in patients with ASCVD was not optimal. The increasing trends in statins prescription among patients with ASCVD subtypes were similar but the differences did not decrease. Consciousness of integrated and successive medical care should be strengthened in China.

Keywords: Cardiovascular disease; Secondary prevention; Statins.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Atherosclerosis / drug therapy*
  • Atherosclerosis / epidemiology
  • Cardiovascular Diseases / drug therapy
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / prevention & control
  • China / epidemiology
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects*
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Logistic Models
  • Male
  • Middle Aged
  • Odds Ratio
  • Patient Discharge / statistics & numerical data*
  • Patient Discharge / trends
  • Prevalence
  • Risk Factors

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors