Statins at Discharge in Acute Coronary Syndromes over the past 10 Years. The Epi-Cardio Registry

pp. 438-445

Abstract

Background: Statins have been incorporated for secondary prevention of cardiovascular disease for over two decades, with a remarkable impact in reducing morbidity and mortality. Currently, the evidence available recommends the use of high-intensity statin therapy in all the patients presenting an acute coronary syndrome.

Objective: The aim of this study was to evaluate the use of statins at discharge in acute coronary syndrome patients included in the Epi-Cardio registry and its variation over the past 10 years.

Methods: Patients hospitalized between 2005 and 2014 with diagnosis of acute coronary syndrome were included; those deceased or without data of the treatment at discharge were excluded. The frequency of indication of statins, agents, doses used over the 10-year period and the indication of high-intensity therapy (rosuvastatin 20-40 mg, atorvastatin 40-80 mg) were analyzed. The use according to the field of care was compared.

Results: 22,905 records were analyzed. The most common agents used were atorvastatin 68%, simvastatin 22.7% and rosuvastatin 9.1%. The temporal trend revealed higher frequency of statin prescription (from 83% in 2005-2007 to 92.5% in 2014), higher doses, lower indication of simvastatin and higher of other agents, and greater use of high-intensity statin therapy from 7.7% in 2005-2007 to 52.6% in 2014. The use of high-intensity therapy was lower in the public health care system.

Conclusions: The frequency of statin indication reaches optimal levels and the use of high-intensity therapy increased during the period evaluated, including over half of the patients. The differences in the public health care system suggest a lower access to treatment. Additional studies are necessary to identify the barriers for implementing high-intensity statin therapy.