Achieving Guideline-Driven High-Intensity Statin Dose in Cardiac Rehabilitation Patients With Coronary Artery Disease
| Autor: | Joy Reardon, Carla Winters, Lars Willy Andersen, Peter Alagona, Alexandra Banathy, Jonathan Lin, Cindy Hudson, Heidi Testa |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Pulmonary and Respiratory Medicine
Adult Male medicine.medical_specialty Statin medicine.drug_class medicine.medical_treatment Coronary Artery Disease 030204 cardiovascular system & hematology Coronary artery disease 03 medical and health sciences 0302 clinical medicine Sex Factors Internal medicine Medicine Humans In patient cardiovascular diseases 030212 general & internal medicine Aged Retrospective Studies Aged 80 and over Rehabilitation Cardiac Rehabilitation business.industry High intensity Age Factors Retrospective cohort study Guideline Statin treatment Middle Aged medicine.disease Practice Guidelines as Topic Female Guideline Adherence Hydroxymethylglutaryl-CoA Reductase Inhibitors Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of cardiopulmonary rehabilitation and prevention. 38(5) |
| ISSN: | 1932-751X |
| Popis: | PURPOSE The 2013 American College of Cardiology/American Heart Association Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults recommends high-intensity statin therapy in patients aged ≤75 y with clinical coronary artery disease (CAD). The effectiveness of cardiac rehabilitation (CR) in lipid management and guideline adherence is unknown. The purpose of this study is to determine whether CR participation affects guideline-driven achievement for statin use. METHODS This multicenter retrospective study evaluated statin utilization in patients pre- and post-CR between January 1, 2014, and August 31, 2015. Records for patients with known CAD who completed 18 or more CR sessions were reviewed for statin-drug use and dose before and after CR and documented statin intolerance. RESULTS Of the total 468 patients, 76% were male with mean age ± SD = 66.0 ± 10.8 y and range of 32 to 89 y. Patients aged ≤75 y (n = 375) showed a modest but statistically significant increase (P = .0006) in high-intensity statin use post-CR (56.3%-61.1%). Males demonstrated a significant increase in high-intensity statin use (P = .0005). Of the 146 patients aged ≤75 y not on high-intensity statins post-CR, only 21 had history of statin intolerance. Of the subjects aged >75 y (n = 93), 91% were already on high- or moderate-intensity statins with no significant change during CR. CONCLUSIONS Patients aged ≤75 y following CR completion increased high-intensity statin use but only by 4.8% and 33% of subjects were inadequately treated. The updated 2013 treatment recommendations simplified statin use, yet substantial data continue to reveal that guideline achievement even post-CR remains limited. |
| Databáze: | OpenAIRE |
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