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Are heart attack victims getting enough high dose statins? New research says no.


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1/30/2015
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Heart disease is one of the leading causes of death among Americans today, which makes it more important for people to get proper treatment before and after a heart attack. But are people getting the right treatment?

Reuters reports on new data about heart treatment. The research shows that most heart patients are not getting enough statins after a heart attack.

Experts pooled data on treatment of patients in the United States after a heart attack. They found that among Americans, less than a third of older heart event patients being discharged from the hospital get the recommended high-intensity statins. The new study looked at prescriptions being filled.

What do federal experts find?

Expert American cardiologists set national guidelines from the American College of Cardiology and American Heart Association. They say the majority of patients should be on a high-dose statin after a serious heart disease-related event like heart attack or bypass surgery.

Dr. Rosenson of the Icahn School of Medicine at Mount Sinai in New York led the study.

He said, “It appears that there’s tremendous reticence in prescription of statin therapy. Whatever the dose of statin people were taking when they came to the hospital was the dose they went out on, the acute event didn’t change it. This is very disappointing. There’s a tremendous amount of confusion. Though the clinical guidelines, which are supported by rigorous studies and high quality results, indicate that high dose statins are better than low dose statins after an acute cardiac event, many doctors appear not to be following them.”

How was the study conducted?

Dr. Rosenson and his team studied a random sample of Medicare beneficiaries ages 65 to 74 who filled a statin prescription after having a heart attack or bypass surgery between the years 2007 and 2009.

What were the results? Out of the more than 8,000 people who filled a statin prescription after one of these events, only 27 percent of the first post-discharge prescriptions were for high-intensity statins, such as 40 to 80 milligrams of atorvastatin (Lipitor) or 80 milligrams of simvastatin (Zocor).

Also less than twenty-five percent of people who were not taking a statin before their hospitalization filled a high-intensity statin prescription on their release. Researchers also said that less than 10 percent of those who had been taking a low-intensity statin changed to a high-intensity statin.

Around 80 percent of people who had already been taking high-intensity statins filled another such prescription right away when leaving the hospital, according to the results in the Journal of the American College of Cardiology. Out off the patients whose first post-discharge prescription fill was for a low-intensity statin, only almost 12 percent switched to a high-intensity dosage within the next year.

Dr. Rosenson commented on this issue saying,

“High intensity statins have been linked to better health outcomes in the short and long term for these patients. It could be that either the doctors are not aware of the guidelines that high intensity therapy is proven to be better, or more likely they are focusing on the (low-density lipoprotein) cholesterol level. There has been confusion on whether or not to dose statins based on LDL cholesterol readings for some patients, but for those who have suffered an acute cardiac event, a high dose is better.”

 



Category: Misdiagnosis and Failure to Diagnose


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