Current Statin Usage for Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention: Multicenter Survey in Korea
Article first published online: 23 JUL 2012
© 2012 Wiley Periodicals, Inc.
Volume 35, Issue 11, pages 700–706, November 2012
How to Cite
Kim, M.-J., Jeon, D. S., Gwon, H.-C., Kim, S.-J., Chang, K., Kim, H.-S., Tahk, S.-J. and for Korean MUSTANG Investigators (2012), Current Statin Usage for Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention: Multicenter Survey in Korea. Clin Cardiol, 35: 700–706. doi: 10.1002/clc.22038
- Issue published online: 14 NOV 2012
- Article first published online: 23 JUL 2012
- Manuscript Revised: 9 JUN 2012
- Manuscript Received: 4 APR 2012
Although high-dose statin therapy has been reported to improve outcomes in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI), patterns of statin usage for such patients have not been reported in real-world clinical practice.
Some clinical factors would affect the pattern of statin usage in patients with ACS.
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).
In real-world clinical practice, high-dose statin treatment is being underused despite extensive evidence for patients with ACS undergoing PCI, particularly in UA/NSTEMI. Efforts are needed to ensure that clinical practice complies with evidence-based guidelines. Clin. Cardiol. 2012 doi: 10.1002/clc.22038
This work was supported financially by Pfizer Pharmaceuticals Korea Ltd., which had no role in the study design, data collection, analysis, manuscript writing, or decision to proceed with publication. The authors have no other funding, financial relationships, or conflicts of interest to disclose.