Abstract
BackgroundStatin remains a mainstay in the prevention and treatment of cardiovascular diseases. Statin utilization has evolved over time in many countries, but data on this topic from China are quite limited. This study aimed to investigate the changing trends of statins prescription, as well as detail the statin utilization through a successive longitudinal study.MethodsThe prescription database was established based on electronic health records retrieved from the hospital information system of Jinshan Hospital, Fudan University from January 2012 to December 2018 in Shanghai, China. The prescription rates and proportions of different statin types and doses among all patients were examined. Sub-analyses were performed when stratifying the patients by age, gender, dose intensity, and preventative intervention.ResultsDuring the study period, a total of 51,083 patients, who were prescribed for statins, were included in this study (mean [SD] age, 59.78 [±13.16] years; 53.60% male, n = 27, 378). The overall statins prescription rate in which patients increased from 2012 (1.24, 95% CI: 1.21-1.27%) to 2018 (3.16, 95% CI: 3.11–3.20%), P < 0.001. Over 90% of patients were given a moderate dose of statins. Patients with a history of coronary and cerebrovascular events (over 32%) were more likely to be prescribed with statins for preventative intervention. Furthermore, our study has witnessed a significant rise in statin therapy in primary and secondary prevention.ConclusionsIn conclusion, statins were frequently prescribed and steadily increased over time in our study period. There were also changes in statin drug choices and dosages. A coordinated effort among the patient, clinical pharmacist, stakeholders and health system is still needed to improve statin utilization in clinical practice in the future.
Highlights
Statin remains a mainstay in the prevention and treatment of cardiovascular diseases
Cholesterol plays a crucial role in the pathogenesis of coronary heart disease (CHD) and Atherosclerotic cardiovascular disease (ASCVD), and it has been a global consensus to prevent and control the cardiovascular risk of ASCVD by reducing blood low-density lipoprotein (LDL) cholesterol (LDL-C) level [6]
The American College of Cardiology (ACC)/American Heart Association (AHA) 2013 guidelines (2013 American College of Cardiology /American Heart Association (ACC/AHA)) cholesterol guidelines recommend that all patients with ASCVD should receive high-dose or moderate-dose statins therapy while ignoring lipid targets, and have recommended statin therapy to a specific group for primary and secondary prevention [7]
Summary
Statin remains a mainstay in the prevention and treatment of cardiovascular diseases. The professional name of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, have been proven to lower the morbidity and mortality of cardiovascular events and widely used in prevention in patients with CVD [2]. It is recommended as the most effective lipidlowering drug at present, which can effectively reduce total cholesterol (TC) and low-density lipoprotein (LDL) [3,4,5].
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