Statin prescription rates among patients with severe dyslipidemia vary by age and are significantly lower among younger patients, according to a research letter published in JAMA Cardiology.
David A. Zidar, MD, PhD, from the Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, and colleagues examined the rate of statin prescriptions among patients screened for dyslipidemia to identify treatment gaps in this patient population.
The researchers used the Explorys registry to collect data from 360 medical centers in the United States. They included 109,980 patients between 20 and 75 years of age who had low-density lipoprotein cholesterol (LDL-C) of 190 mg/dL or greater in the study.
The prescription rate for patients with severe dyslipidemia without diabetes or atherosclerotic cardiovascular disease (ASCVD) was 66%. Similarly, the prescription rate for patients with diabetes but without ASCVD was 69%, and the rate for patients with ASCVD but without diabetes was 68%.
Statins were prescribed in 32% of patients in their 30s, 47% of patients in their 40s, and 61% of patients in their 50s. The researchers found that age was the most important predictor of prescription among patients with an LDL-C level of 190 mg/dL or greater. Other predictors included male sex, nonwhite race, and self-pay status.
“This finding has particular relevance given the early onset of ASCVD and cardiovascular death observed in familial hypercholesterolemia studies from the pre-statin era,” the authors wrote. “For this reason, for patients with primary LDL-C elevation level of 190 mg/dL or greater and who are 21 years or older, current guidelines recommend against the use of an ASCVD risk calculation, which could inappropriately lead to deferral of statin therapy for these high-risk patients.”
- Al-Kindi SG, DeCicco A, Longenecker CT, et al. Rate of statin prescription in younger patients with severe dyslipidemia. JAMA Cardiol. 2017. doi:10.1001/jamacardio.2016.5162