Prescribing of Statins Following ACS in the UK
Prescribing of Statins Following ACS in the UK
National Institute for Health and Clinical Excellence (NICE) guideline CG67 recommends that acute coronary syndrome (ACS) cases are treated with high-intensity statins (defined as statins used in doses that produce greater cholesterol lowering than simvastatin 40 mg). The objective of this study was to describe current UK prescribing of statins following ACS. This study used data from linkage between the Myocardial Ischaemia National Audit Project (MINAP) database and the General Practice Research Database (GPRD). The study included adults aged 40+ with a discharge diagnosis in MINAP of myocardial infarction, troponin positive or negative ACS discharged alive to home. A total of 6,138 ACS cases were included. Most ACS cases were prescribed both a statin at hospital discharge and by their GP, however, 340 of the 6,138 ACS cases (5.5%) had no record of statin prescription from either source. Of the ACS cases prescribed a statin by their GP, 30.1% received a high-intensity statin dose. At year four, 43% (95% confidence interval [CI] 41–45%) of ACS cases prescribed a statin remained on treatment (42% for those starting low and 45% for high intensity). In conclusion, statin therapy is provided to most ACS cases in the UK but duration and dosage is shorter and lower than recommended.
Cardiovascular disease (CVD) is the leading cause of death in England and Wales (124,000 deaths in 2005) and for every fatality, there are at least two people who have a major non-fatal CVD event. Myocardial infarction (MI) is associated with substantial morbidity and mortality. There is a high risk of recurrence after the initial event. Recommendations on the secondary prevention of cardiovascular disease for patients in primary and secondary care have been published in guidelines from the National Institute for Health and Clinical Excellence (NICE) in England. In the May 2008 CG67 guideline, high-intensity dosage of statin (defined as statins used in doses that produce greater cholesterol lowering than simvastatin 40 mg) is recommended for patients with acute coronary syndrome (ACS).
The main objectives of this study were to describe current prescribing of statins and assess the extent of high-intensity prescribing following an ACS in the UK. Persistence with statin treatment over time was also evaluated.
Abstract and Introduction
Abstract
National Institute for Health and Clinical Excellence (NICE) guideline CG67 recommends that acute coronary syndrome (ACS) cases are treated with high-intensity statins (defined as statins used in doses that produce greater cholesterol lowering than simvastatin 40 mg). The objective of this study was to describe current UK prescribing of statins following ACS. This study used data from linkage between the Myocardial Ischaemia National Audit Project (MINAP) database and the General Practice Research Database (GPRD). The study included adults aged 40+ with a discharge diagnosis in MINAP of myocardial infarction, troponin positive or negative ACS discharged alive to home. A total of 6,138 ACS cases were included. Most ACS cases were prescribed both a statin at hospital discharge and by their GP, however, 340 of the 6,138 ACS cases (5.5%) had no record of statin prescription from either source. Of the ACS cases prescribed a statin by their GP, 30.1% received a high-intensity statin dose. At year four, 43% (95% confidence interval [CI] 41–45%) of ACS cases prescribed a statin remained on treatment (42% for those starting low and 45% for high intensity). In conclusion, statin therapy is provided to most ACS cases in the UK but duration and dosage is shorter and lower than recommended.
Introduction
Cardiovascular disease (CVD) is the leading cause of death in England and Wales (124,000 deaths in 2005) and for every fatality, there are at least two people who have a major non-fatal CVD event. Myocardial infarction (MI) is associated with substantial morbidity and mortality. There is a high risk of recurrence after the initial event. Recommendations on the secondary prevention of cardiovascular disease for patients in primary and secondary care have been published in guidelines from the National Institute for Health and Clinical Excellence (NICE) in England. In the May 2008 CG67 guideline, high-intensity dosage of statin (defined as statins used in doses that produce greater cholesterol lowering than simvastatin 40 mg) is recommended for patients with acute coronary syndrome (ACS).
The main objectives of this study were to describe current prescribing of statins and assess the extent of high-intensity prescribing following an ACS in the UK. Persistence with statin treatment over time was also evaluated.
Source...