Abstract 18613: Utilization of High-Potency Statin Therapy Following Hospitalization for CHD Among Medicare Beneficiaries
Background: Evidence-based guidelines recommend high-potency statins for secondary prevention in high-risk patients including individuals hospitalized for coronary heart disease (CHD) events. In these patients, initiation of this therapy is recommended upon hospital discharge.
Aim: Investigate the proportion of Medicare beneficiaries who fill a prescription for a high potency statin following discharge and within 365 days after hospital discharge for an incident CHD event.
Methods: This study included Medicare beneficiaries ≥ 65 years with no documented CHD history in the prior year who were hospitalized and filled a statin following an incident CHD event (myocardial infarction or coronary revascularization procedure) in 2007, 2008 or 2009. High-potency statins included atorvastatin 20 mg to 80 mg, rosuvastatin 10 mg to 40 mg and simvastatin 40 to 80 mg daily.
Results: Among 9,455 Medicare beneficiaries filling a statin following an incident CHD hospitalization, 33.8% and 40.2% filled prescriptions for high-potency statins within 90 and 365 days, respectively. The proportion filling a prescription for a high-potency statin declined between 2007 and 2009. After multivariable adjustment, more recent calendar time, progressively older age and higher Charlson scores were associated with a lower likelihood of filling a prescription for a high potency statins and Asians were more likely to fill a prescription for a high potency statin (Table).
Conclusions: The majority of Medicare beneficiaries who will a statin following hospitalization for CHD do not fill a high potency statin. The under-utilization of high-potency statin therapy represents a major obstacle to lowering the burden of recurrent cardiovascular events.
- © 2013 by American Heart Association, Inc.