Trends in statin utilization among adults with severe peripheral artery disease including critical limb ischemia in an integrated healthcare delivery system
| Autor: | Teresa N. Harrison, Somjot S Brar, Songyue Chen, Stephanie R. Reading, Katherine E Mues, Kristi Reynolds, Jin-Wen Y Hsu, Kiran Philip, Lei Qian, Keri L. Monda |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Statin Time Factors Arterial disease medicine.drug_class Critical Illness Population Disease Severity of Illness Index California Peripheral Arterial Disease Healthcare delivery Ischemia Risk Factors Internal medicine Medicine Humans Peripheral artery disease (PAD) Practice Patterns Physicians' education Aged Dyslipidemias Retrospective Studies Aged 80 and over education.field_of_study business.industry Delivery of Health Care Integrated Incidence Critical limb ischemia Middle Aged medicine.disease Drug Utilization Discontinuation body regions Treatment Outcome Practice Guidelines as Topic Female Guideline Adherence medicine.symptom Hydroxymethylglutaryl-CoA Reductase Inhibitors Cardiology and Cardiovascular Medicine business |
| Zdroj: | Vascular medicine (London, England). 25(1) |
| ISSN: | 1477-0377 |
| Popis: | Evidence suggests that statin therapy in patients with peripheral artery disease (PAD) is beneficial yet use remains suboptimal. We examined trends in statin use, intensity, and discontinuation among adults aged ⩾ 40 years with incident severe PAD and a subset with critical limb ischemia (CLI) between 2002 and 2015 within an integrated healthcare delivery system. Discontinuation of statin therapy was defined as the first 90-day gap in treatment within 1 year following PAD diagnosis. We identified 11,059 patients with incident severe PAD: 31.1% ( n = 3442) with CLI and 68.9% ( n = 7617) without CLI. Mean (SD) age was 68.6 (11.3) years, 60.5% were male, 54.2% white, 23.2% Hispanic, and 16.2% black. Statin use in the year before diagnosis increased from 50.4% in 2002 to 66.0% in 2015 (CLI: 43.7% to 68.0%; without CLI: 53.1% to 64.2%, respectively). The proportion of patients on high-intensity statins increased from 7.3% in 2002 to 41.9% in 2015 (CLI: 7.2% to 39.4%; without CLI: 7.4% to 44.2%, respectively). Of the 40.5% ( n = 4481) who were not on a statin in the year before diagnosis, 13.5% ( n = 607) newly initiated therapy within 1 month (CLI: 10.1% ( n = 150); without CLI: 15.3% ( n = 457)). Following diagnosis, 12.5% ( n = 660) discontinued statin therapy within 1 year (CLI: 15.5% ( n = 202); without CLI: 11.5% ( n = 458)). Although use of statins increased from 2002 to 2015, a substantial proportion of the overall PAD and CLI subpopulation remained untreated with statins, representing a significant treatment gap in a population at high risk for cardiovascular events and adverse limb outcomes. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|