The appropriateness of the use of statins for the secondary and primary prevention of atherosclerotic cardiovascular disease: a cross-sectional study from Jordan.

Abstract

The appropriate use of statins to lower blood cholesterol remains the main strategy for primary and secondary prevention of atherosclerotic cardiovascular diseases (ASCVD). Here, we aim to examine the pattern of statin use and the appropriateness of dyslipidemia treatment in patients with or without established ASCVD according to the latest American Heart Association/American College of Cardiology (AHA/ACC) guidelines. This is a cross-sectional study conducted in the largest tertiary government hospital in Jordan. Data was collected through face-to-face interviews and the review of medical records. A total of 752 patients were enrolled, 740 (98.4%) patients were on atorvastatin, 8 (1.1%) were on simvastatin, 3 (0.4%) were on rosuvastatin, and 1 (0.1%) was on fluvastatin. The majority of patients, 550 (73.1%), used statins for secondary prevention. Only half of the patients, 367 (49.7%), received statin treatment at the intensity recommended by the guidelines. A large percentage of patients, 306 (40.7%), were undertreated with statins, and the management of dyslipidemia was not accompanied by appropriate follow-up. Based on the latest guidelines' recommendations, older age (p = 0.027), longer duration of statin use (p = 0.005), increased number of ASCVDs (p < 0.001), using statins other than atorvastatin (p = 0.004), and a history of angina (p < 0.001) or stroke (p < 0.001) were associated with undertreatment with statins. The use of statins was not in concordance with the guidelines. Many of the patients surveyed were undertreated and adequate follow-up to identify the extent of patients' compliance and response was missing.