The following is the summary of “Ten-Year Evolution of Statin Eligibility and Use in a Population-Based Cohort” published in the January 2023 issue of Cardiovascular Disease by Rochat, et al.
The cross-sectional design and limited follow-up of studies indicating inadequate management of dyslipidemia are limitations. Researchers evaluated statin use, including intensity, using recent data from a population-based cohort with a 10-year follow-up. Specifically, researchers analyzed information from the CoLaus|PsyColaus study, which included 4,655 people at the start (between 2003 and 2006) and 3,587 people at the end of the study (10 years later) from 2014 to 2017. To do this, researchers used the Systemic Coronary Risk Evaluation risk prediction model, Pooled Cohort Equations, and participants’ individual risk scores to estimate their 10-year cardiovascular risk, as recommended by the American Heart Association/American College of Cardiology and the European Society of Cardiology (ESC).
First, researchers checked for statin eligibility and statin-recommendation compliance at 2 intervals. Researchers also analyzed the statin usage rate in people who did not have atherosclerotic cardiovascular disease at baseline but developed it throughout the follow-up period 2014-2017 (secondary prevention). Throughout the study, 219 individuals experienced the onset of their first atherosclerotic cardiovascular event. According to the European Society of Cardiology (ESC) and the American Heart Association/American College of Cardiology (AHA/ACC), eligible patients taking statins increased from 25.9% in 2003-2006 to 35.9% in 2014-2017. However, from 2014-2017, only 28.2% of treated individuals (15.8% from 2003-2006) met ESC criteria for low-density lipoproteins cholesterol, and women reached targets less frequently.
From 2014-2017, just 18% of people took high-intensity statins, with women taking them at a lower rate than men (14% vs. 22%). Only 74% of people who could have benefitted from statins were taking them for secondary prevention. Conclusively, current data suggest that dyslipidemia is undertreated, and undertreated women are less likely to receive high-intensity treatment, making secondary prevention an area where improvements should be made.
Source: sciencedirect.com/science/article/pii/S0002914922010761