Vnitr Lek 2003, 49(4):285-290
[Long-term treatment with statins in patients with ischemic heart disease after coronary angioplasty].
- II. interní klinika 1. lékarské fakulty UK a VFN, Praha.
UNLABELLED: Long-term statin therapy is the corner-stone in management of patients with coronary artery disease.
PURPOSE OF STUDY: The aim of our study was to analyze the state of the statin therapy at patients undergoing percutaneous coronary intervention (PCI) and to determine predictors of long-term statin treatment.
METHODS: We performed a retrospective study in 520 patients who underwent percutaneous coronary angioplasty in 2nd Dept. of Internal Medicine, 1st School of Medicine, Charles University, Prague during the year 2000. Data were collected from hospital records and from a mailed questionnaire.
RESULTS: The response rate was 61.9% and the average response time was 11.6 +/- 3.5 months after PCI. Long-term statin therapy was prescribed in 52.5%. In patients with hypercholesterolemia 67.1% were treated in comparison with 32.3% treated patients without this diagnosis (p < 0.0001). Patients aged 70 years and older were treated significantly less frequently then younger individuals (30.6% vs. 61.3%, p < 0.0001). Patients with a history of prior revascularization procedure were treated significantly more often then patients undergoing the first procedure (64.8% vs. 49.8%, p < 0.05). Multivariate logistic regression analysis was applied to detect significant predictors of long-term statin therapy. Only hypercholesterolemia and statin prescription at discharge were identified as independent positive predictors, whereas age > or = 70 years and male gender had negative predictive value.
CONCLUSION: By course of evidence-based medicine, patients who underwent PCI in our study are undertreated by statins. Statin treatment should be initiated in all patients treated by PCI with increased cardiovascular risk. Patients at defined risk for undertreatment are mainly older patients and men. The prescription of statin therapy at the time of hospital discharge appears to be a very effective tool to improve long-term statin therapy.
Keywords: Aged; Angioplasty, Balloon, Coronary; Coronary Disease, complications, ; Female; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors, therapeutic use, ; Hypercholesterolemia, complications, ; Logistic Models; Male; Middle Aged; Retrospective Studies; Risk Factors
Published: April 1, 2003 Show citation