Statin Utilization Trend in Primary and Secondary Prevention of Cardiovascular Diseases in a Teaching Hospital

S. Umarje, Asawari Raut, P. Dave, N. M. James
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Abstract

Objective To conduct risk assessment and assess the choice of statins with regard to cardiovascular diseases (CVDs). Methodology This is a cross-sectional observation study conducted on 500 patients visiting a teaching hospital. Medical records were used to obtain patient characteristics and type, dose, and regimen of prescribed statin. Prescribed statin dose was evaluated using standard prescribing guidelines by American College of Cardiology/American Heart Association. Result Out of the 500 patients studied, 70% (350) of patients were prescribed statin therapy for a CVD and 30% had at least 1 CVD risk factor. Proportion of males was higher. Mean age of patients with statin therapy for coexisting CVD was 61.16 ± 12.87. Among those with at least 1 cardiovascular risk factor but without CVD, 66% had risk score more than 7.5 out of 10 suggestive of high risk for CVDs within 10 years. Atorvastatin and rosuvastatin were the preferred choice of statin therapy, with higher preference for atorvastatin. Dosing criteria were well-met for secondary prevention; whereas, underdosing was prevalent among users of fixed-dose combinations and among patients prescribed a statin for primary prevention of CVDs. Conclusion Lack of use of risk scores may lead to underdosing and underutilization of statins.
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他汀类药物在某教学医院心血管疾病一级和二级预防中的应用趋势
目的对心血管疾病(cvd)患者进行风险评估,评价他汀类药物的选择。本研究是对某教学医院的500名患者进行横断面观察研究。使用医疗记录获取患者特征、类型、剂量和处方他汀类药物的治疗方案。使用美国心脏病学会/美国心脏协会的标准处方指南评估他汀类药物的处方剂量。结果在研究的500名患者中,70%(350)的患者接受了他汀类药物治疗CVD, 30%的患者至少有1种CVD危险因素。男性比例较高。合并CVD患者接受他汀类药物治疗的平均年龄为61.16±12.87岁。在那些至少有1个心血管危险因素但没有心血管疾病的人中,66%的风险评分超过7.5分(满分10分),表明10年内心血管疾病的风险很高。阿托伐他汀和瑞舒伐他汀是他汀类药物治疗的首选,对阿托伐他汀的偏好更高。二级预防的给药标准完全符合;然而,在固定剂量组合的使用者和为心血管疾病一级预防而使用他汀类药物的患者中,剂量不足普遍存在。结论缺乏使用风险评分可能导致他汀类药物的剂量不足和利用不足。
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