{"title":"Prevalence and Predictors of Statin Treatment Among Patients With Chronic Heart Failure at a Tertiary-Care Center in Thailand.","authors":"Pattamawan Kosuma, Arom Jedsadayanmata","doi":"10.1177/1179546819855656","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Statins play important roles in the prevention of atherosclerotic vascular diseases; however, their beneficial effects in patients with chronic heart failure (CHF) are uncertain. This study aimed to investigate the prevalence and predictors of treatment with statins to better understand their prescribing patterns in CHF patients.</p><p><strong>Methods: </strong>We conducted a cross-sectional study in patients with first-time diagnoses of CHF receiving care in the outpatient clinics affiliated with a tertiary-care teaching hospital in Thailand. Data were retrieved from electronic claims database. Multivariable logistic regression was used to identify independent predictors of treatment with statins.</p><p><strong>Results: </strong>A total of 3445 patients were included in this study. Among them, 1908 (55.4%) were prescribed statins, with most of them (89.7%) receiving simvastatin 20 mg daily. Factors independently associated with the statin treatment include the following: being male (odds ratio [OR] = 1.21, 95% confidence interval [CI] = 1.02-1.44, <i>P</i> = .03); diagnoses of dyslipidemia (OR = 4.88, 95% CI = 3.88-6.14, <i>P</i> < .001), ischemic heart disease (OR = 2.71, 95% CI = 2.18-3.36, <i>P</i> < .001), diabetes (OR = 1.95, 95% CI = 1.55-2.46, <i>P</i> < .001), or cerebrovascular disease (OR = 1.64, 95% CI = 1.12-2.40, <i>P</i> = .01); and receipt of angiotensin-converting enzyme inhibitors (OR = 3.44, 95% CI = 2.87-4.13, <i>P</i> < .001), aspirin (OR = 2.79, 95% CI = 2.30-3.40, <i>P</i> < .001), non-dihydropyridine calcium channel blockers (OR = 2.35, 95% CI = 1.30-4.24, <i>P</i> = .004), organic nitrates (OR = 2.04, 95% CI = 1.16-3.58, <i>P</i> = .01), beta-blockers (OR = 1.51, 95% CI = 1.23-1.84, <i>P</i> < .001), and digoxin (OR = 0.65, 95% CI = 0.50-0.86, <i>P</i> = .002).</p><p><strong>Conclusions: </strong>Statins were prescribed to more than half of the newly diagnosed CHF patients. Independent predictors of statin treatments include hypercholesterolemia and comorbidities indicative of high atherosclerotic vascular risk as well as drugs recommended as cardiovascular protective therapy for CHF patients.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2019-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9e/9f/10.1177_1179546819855656.PMC6558538.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Medicine Insights. Cardiology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/1179546819855656","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2019/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Statins play important roles in the prevention of atherosclerotic vascular diseases; however, their beneficial effects in patients with chronic heart failure (CHF) are uncertain. This study aimed to investigate the prevalence and predictors of treatment with statins to better understand their prescribing patterns in CHF patients.
Methods: We conducted a cross-sectional study in patients with first-time diagnoses of CHF receiving care in the outpatient clinics affiliated with a tertiary-care teaching hospital in Thailand. Data were retrieved from electronic claims database. Multivariable logistic regression was used to identify independent predictors of treatment with statins.
Results: A total of 3445 patients were included in this study. Among them, 1908 (55.4%) were prescribed statins, with most of them (89.7%) receiving simvastatin 20 mg daily. Factors independently associated with the statin treatment include the following: being male (odds ratio [OR] = 1.21, 95% confidence interval [CI] = 1.02-1.44, P = .03); diagnoses of dyslipidemia (OR = 4.88, 95% CI = 3.88-6.14, P < .001), ischemic heart disease (OR = 2.71, 95% CI = 2.18-3.36, P < .001), diabetes (OR = 1.95, 95% CI = 1.55-2.46, P < .001), or cerebrovascular disease (OR = 1.64, 95% CI = 1.12-2.40, P = .01); and receipt of angiotensin-converting enzyme inhibitors (OR = 3.44, 95% CI = 2.87-4.13, P < .001), aspirin (OR = 2.79, 95% CI = 2.30-3.40, P < .001), non-dihydropyridine calcium channel blockers (OR = 2.35, 95% CI = 1.30-4.24, P = .004), organic nitrates (OR = 2.04, 95% CI = 1.16-3.58, P = .01), beta-blockers (OR = 1.51, 95% CI = 1.23-1.84, P < .001), and digoxin (OR = 0.65, 95% CI = 0.50-0.86, P = .002).
Conclusions: Statins were prescribed to more than half of the newly diagnosed CHF patients. Independent predictors of statin treatments include hypercholesterolemia and comorbidities indicative of high atherosclerotic vascular risk as well as drugs recommended as cardiovascular protective therapy for CHF patients.
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