Is Statin Use Increasing Among MI Patients?

In recent years, more patients have been started on high-intensity statins after being hospitalized for myocardial infarction (MI), researchers reported.

Before 2011, few patients began high-intensity statins after discharge, but researchers hypothesized that black box warnings, updated guidelines, and the availability of a generic version of atorvastatin may have led to a change in statin use trends in the next few years.

To investigate, Robert S. Rosenson, MD, and colleagues, evaluated data on use of high-intensity statins in the United States between 2011 and 2014. The analysis included 42,893 patients from the MarketScan database who were aged 19 to 64 years and had commercial health insurance, as well as 75,096 patients from the Medicare database who were aged 66 to 75 years.

All patients had been discharged from the hospital following MI. After discharge, all patients included filled a statin prescription (high-intensity statins included were atorvastatin 40 or 80 mg and rosuvastatin 20 or 40 mg) within 30 days.

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Among MarketScan patients, 33.5% of the filled prescriptions from January through March 2011 were for high-intensity statins, compared with 71.7% of prescriptions in October through November 2014. A similar trend in prescription increases during those time periods was observed in Medicare patients (24.8% to 57.5%).

In addition, high-intensity statin use after hospital discharge was increasingly seen in this period among patients initiating treatment and in patients who were taking low- or moderate-intensity statins before being hospitalized.

Men were more likely to receive a high-intensity statin prescription, as were patients who received beta-blocker and antiplatelet prescriptions. Individuals who attended cardiac rehabilitation within 30 days of hospital discharge were also more likely to receive a high-intensity statin prescription.

The researchers were pleased with the trend showing increasing use of high-intensity statins but still believe there is room for improvement. "Despite this favorable trend, a substantial percentage of patients filled low- or moderate-intensity statin prescriptions following hospital discharge for MI in 2014. The present study highlights the need to continue efforts to increase high-intensity statin use following hospital discharge for MI," the study’s authors wrote.

—Lauren LeBano

Reference:

Rosenson RS, Farkouh ME, Mefford M, et al. Trends in use of high-intensity statin therapy after myocardial infarction, 2011 to 2014. J Am Coll Cardiol. 2017; doi:10.1016/j.jacc.2017.03.585.