Abstract 13969: Changes in Statin Prescribing Patterns and Cholesterol Values Following Coronary CT Angiography
Introduction: The relationship of coronary artery disease (CAD), as visualized on coronary CT angiography (CCTA), to changes in provider prescribing patterns for statin medications and subsequent cholesterol levels is unknown.
Hypothesis: The presence and severity of CAD on CCTA may impact provider utilization of statins and patient cholesterol levels early following CCTA.
Methods: We studied consecutive patients within the military healthcare system without known prior CAD who were clinically referred for CCTA at a single institution. Demographic variables and statin prescription status were extracted from military healthcare electronic records. CCTA results were coded as the presence of no CAD, <50%, or ≥50% lumen stenosis of ≥1 major epicardial vessel. Intensification of statin treatment was defined as a new statin prescription, increase in statin dosage, or change to a more potent statin preparation within 6-months of CCTA. Cholesterol values were surveyed at 6-months following CCTA.
Results: 1157 patients (median age 50 years; 59% males) were studied. Prior to CCTA, 357 (31%) were taking a statin medication and cholesterol testing was performed a median of 35 days prior to CCTA. Mean baseline total, LDL and HDL cholesterol values were 200±42, 121±36 and 50±16 mg/dl, respectively. On CCTA, 618 (53%) had no CAD, 421 (36%) non-obstructive CAD and 118 (10%) at least one vessel with ≥50% stenosis. Within 6 months of CCTA, statin use increased to 39% (459/1157) of the entire cohort (p<0.001). The presence and severity of CAD on CCTA was significantly associated with intensification of statin therapy and a reduction in total and LDL cholesterol levels within 6 months of CCTA testing (Figure).
Conclusion: The presence and severity of coronary artery disease on CCTA is associated with an early increase in statin utilization and a reduction in total and LDL cholesterol levels among patients within a healthcare system without financial barriers to care or medications.
- © 2011 by American Heart Association, Inc.