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Trends in Use of High-Intensity Statin Therapy After Myocardial Infarction, 2011 to 2014
Trends in Use of High-Intensity Statin Therapy After Myocardial Infarction, 2011 to 2014
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Abstract
Background
Data prior to 2011 suggest that a low percentage of patients
hospitalized for acute coronary syndromes filled high-intensity statin
prescriptions upon discharge. Black-box warnings, generic availability
of atorvastatin, and updated guidelines may have resulted in a change in
high-intensity statin use.
Objectives
The aim of this study was to examine trends and predictors of
high-intensity statin use following hospital discharge for myocardial
infarction (MI) between 2011 and 2014.
Methods
Secular trends in high-intensity statin use following hospital
discharge for MI were analyzed among patients 19 to 64 years of age with
commercial health insurance in the MarketScan database (n = 42,893) and
66 to 75 years of age with U.S. government health insurance through
Medicare (n = 75,096). Patients filling statin prescriptions within 30
days of discharge were included. High-intensity statins included
atorvastatin 40 or 80 mg and rosuvastatin 20 or 40 mg.
Results
The percentage of beneficiaries whose first statin prescriptions filled
following hospital discharge for MI were for high-intensity doses
increased from 33.5% in January through March 2011 to 71.7% in October
through November 2014 in MarketScan and from 24.8% to 57.5% in Medicare.
Increases in high-intensity statin use following hospital discharge
occurred over this period among patients initiating treatment (30.6% to
72.0% in MarketScan and 21.1% to 58.8% in Medicare) and those taking
low- or moderate-intensity statins prior to hospitalization (from 27.8%
to 62.3% in MarketScan and from 12.6% to 45.1% in Medicare). In 2014,
factors associated with filling high-intensity statin prescriptions
included male sex, filling beta-blocker and antiplatelet agent
prescriptions, and attending cardiac rehabilitation within 30 days
following discharge.
Conclusions The use of high-intensity statins following hospitalization for MI increased progressively from 2011 through 2014.
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