Pharmacotherapy and Prescribing Patterns for Statins in patients with Acute Coronary Syndrome in Greece

Postgraduate Thesis uoadl:1708899 520 Read counter

Unit:
Κατεύθυνση Κλινική Φαρμακευτική
Library of the School of Science
Deposit date:
2017-07-10
Year:
2017
Author:
Karavitaki Marilena
Supervisors info:
Σοφία Μαρκαντώνη-Κυρούδη, Καθηγήτρια Τμήματος Φαρμακευτικής, Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών
Original Title:
Φαρμακοθεραπεία και Πρότυπα Συνταγογράφησης Στατινών σε Ασθενείς με Οξύ Στεφανιαίο Σύνδρομο στην Ελλάδα
Languages:
Greek
Translated title:
Pharmacotherapy and Prescribing Patterns for Statins in patients with Acute Coronary Syndrome in Greece
Summary:
Introduction
Statins are the most extensively used LDL-C (Low-density lipoprotein – Cholesterol) lowering agents as they are considered to the most potent and best tolerated. The American College of Cardiology/American Heart Association (ACCF/AHA) 2013 guidelines recommend that all patients with an ACS (Acute Coronary Syndrome) should receive high intensity statin therapy irrespective of baseline LDL-C level. High intensity statin therapy includes atorvastatin 40-80 mg or rosuvastatin 20-40 mg and reduces LDL-C by ≥50%. These regimens due to their LDL-lowering and pleiotropic effects, reduce the risk of another ACS and the risk of cardiovascular death. Other multicenter retrospective studies have concluded that the majority of ACS patients in the USA are not prescribed high-intensity statins after a major coronary event.

The objective of study
The purpose of the present multicenter retrospective study was to evaluate the prescribing trends of high intensity statins early in the course of an ACS in patients in Greece (2012-2016).

Methodology
Medical and pharmaceutical data of patients with ACS (2012-2016) were retrospectively collected by using electronic pharmacy records. The study was conducted at four hospitals: “Evaggelismos” General Hospital of Athens, “NNA” Navy Hospital of Athens “251” Hellenic Air Force General Hospital and “HYGEIA” Diagnostic and Therapeutic Center of Athens. Demographics, baseline HDL, LDL, total cholesterol, CRP, names and dosages of statins prescribed, days of hospitalization and in-hospital mortality were recorded. The patients, who were included, were ≥18 years old and were admitted into hospital with ACS and identified from the hospitalisation data sets using relevant ICD-10 codes.

Results
Two thousand and eight (2708) patients met the inclusion criteria. 41.8% of them received high-intensity therapy, 37.2% moderate and only 0,2% low- intensity therapy. About 19.8% of them did not receive any statin therapy during their hospitalization. Of those patients who received high-intensity therapy, atorvastatin 40 mg was the most common regimen prescribed followed by rosuvastatin 20 mg. Only 29.8% of patients aged >75 received intensive regimens. A significant correlation was found between the decision to prescribe any statin and the baseline LDL levels (p<0.05). Of those patients who did not take any statin medication, the majority had baseline LDL < 129 mg/dl. An upward trend (a 15.3% increase) in high-intensity statin prescription was noted over the period 2012-2016.

Discussion and Conclusions
The majority of ACS patients in the four Greek Hospitals included in the study did not receive high intensity statins but the percentage that did receive these regimens was much higher than those percentages reported in similar studies in USA. Furthermore an upward trend in high intensity statin-use, over the last few years, was noted . However, many patients were not prescribed statins at all.
Main subject category:
Science
Other subject categories:
Pharmacy
Keywords:
statins, acute coronary syndrome, Greece
Index:
Yes
Number of index pages:
2
Contains images:
Yes
Number of references:
75
Number of pages:
105
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