Factors associated with time to initiation of a PCSK9 inhibitor after hospital discharge for acute myocardial infarction
| Autor: | Robert S. Rosenson, Jason Exter, Lisandro D. Colantonio, Emily C. McKinley, Vera Bittner, Paul Muntner, Ligong Chen, Stephanie R. Reading, Kate K. Orroth, Todd M. Brown |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Statin medicine.drug_class Endocrinology Diabetes and Metabolism Myocardial Infarction Aftercare Medicare Ezetimibe Internal medicine Internal Medicine medicine Hospital discharge Humans Cumulative incidence Myocardial infarction Aged Nutrition and Dietetics business.industry PCSK9 Anticholesteremic Agents PCSK9 Inhibitors Odds ratio medicine.disease Atherosclerosis Confidence interval Hospitals Patient Discharge United States Hydroxymethylglutaryl-CoA Reductase Inhibitors Proprotein Convertase 9 Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Journal of clinical lipidology. 16(1) |
| ISSN: | 1933-2874 |
| Popis: | Background Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) lower atherosclerotic cardiovascular disease (ASCVD) event risk. Objective Analyze patient characteristics associated with time to PCSK9i initiation following an acute myocardial infarction (AMI). Methods We analyzed characteristics of patients ≥21 years of age in the Marketscan or Medicare databases who initiated a PCSK9i 0-89 days, 90-179 days, or 180-365 days after an AMI between July 2015 and December 2018 (n=1,705). We estimated the cumulative incidence of recurrent ASCVD events before PCSK9i initiation. Results Overall, 42%, 25%, and 33% of patients who initiated a PCSK9i did so 0-89 days, 90-179 days, and 180-365 days following AMI hospital discharge, respectively. Taking ezetimibe prior to AMI hospitalization and initiating ezetimibe within 30 days after AMI hospital discharge were each associated with a higher likelihood of PCSK9i initiation in the 0-89 days versus 180-365 days post-discharge (adjusted odds ratio [OR] 1.83, 95% confidence interval [95%CI] 1.35-2.49 and 1.76, 95%CI 1.11-2.80, respectively). Statin use before and statin initiation within 30 days after AMI hospitalization were associated with a lower likelihood of PCSK9i initiation 0-89 days versus 180-365 days post-discharge (adjusted OR 0.64, 95%CI 0.49-0.84 and 0.39, 95%CI 0.28-0.54, respectively). Overall, 8.0%, 10.5%, and 12.5% of patients had an ASCVD event at 90, 180, and 365 days following AMI hospital discharge and before initiating a PCSK9i, respectively. Conclusion Among patients initiating a PCSK9i after AMI, a low proportion did so within 89 days of hospital discharge. Many patients had a recurrent ASCVD event before treatment initiation. |
| Databáze: | OpenAIRE |
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