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Current statin usage for patients with acute coronary syndrome undergoing percutaneous coronary intervention: multicenter survey in korea Full Text
Clinical Cardiology, 07/26/2012
Clinical Article
Kim MJ et al. – In real–world clinical practice, high–dose statin treatment is being underused despite extensive evidence for patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI), particularly in unstable angina/non–ST–elevated myocardial infarction (UA/NSTEMI). Efforts are needed to ensure that clinical practice complies with evidence–based guidelines.
Methods- In the multicenter prospective registry, 3362 patients with ACS who underwent PCI were analyzed.
- High–dose statin treatment was defined as atorvastatin ≥40 mg or rosuvastatin ≥20 mg per day.
- The patterns of statin usage were investigated for 30 days after the index PCI.
- High–dose statins were administered prior to PCI to 13.7% and 19.6% of patients with unstable angina/non–ST–elevated myocardial infarction (UA/NSTEMI) and ST–elevated myocardial infarction (STEMI), respectively (P < 0.001).
- After PCI, 476 (14.2%) patients were maintained on high–dose statins, and 550 (16.4%) patients received no statins.
- Independent factors associated with high–dose statin usage after PCI were STEMI (odds ratio [OR]: 1.704, 95% confidence interval [CI]: 1.321–2.197, P < 0.001), high total cholesterol level (OR: 1.445, 95% CI: 1.136–1.837, P = 0.003), and current smoker (OR: 1.556, 95% CI: 1.206–2.008, P < 0.011).
- The absence of hypercholesterolemia was an independent factor determining the nonuse of statins (OR: 0.229, 95% CI: 0.148–0.353, P < 0.001).