Statin Utilization for Primary Prevention of Cardiovascular Disease in Patients Developing First ST-Segment Elevation Myocardial Infarction: A Malaysian Retrospective Cohort Study

Overview

Journal Health Sci Rep

Specialty General Medicine

Date 2025 Mar 5

PMID 40041778

Authors

Abdullah Faiz Zaihan

Shairyzah Ahmad Hisham

Aina Yazrin Ali Nasiruddin

Chia Siang Kow

Syed Shahzad Hasan

Dinesh Sangarran Ramachandram

Affiliations

Soon will be listed here.

Abstract

Background And Aims: This retrospective cohort study aimed to determine the utilization rate of statin therapy for primary prevention of cardiovascular disease (CVD) and factors associated with its use in patients prior to experiencing their first ST-elevation myocardial infarction (STEMI).

Methods: The study included 177 patients admitted for their first episode of STEMI at a Malaysian secondary hospital in 2020. Data were retrospectively collected from the electronic health information system. Logistic regression analysis was performed to identify significant predictors of statin therapy utilization for primary prevention.

Results: Of the 177 patients, only 15.8% ( = 28) had been prescribed statin therapy for the primary prevention of CVD prior to their first STEMI. Hypertension and dyslipidemia were identified as significant predictors of statin use, with adjusted odds ratios (AOR) of 9.570 (95% CI: 1.859-49.281) and 37.900 (95% CI: 6.716-213.87), respectively. Follow-up data indicated significantly reduced cholesterol levels post-STEMI, demonstrating the lipid-lowering effectiveness of statin therapy.

Conclusion: This study highlights the low utilization rate of statin therapy for primary prevention of CVD among patients prior to their first STEMI. Despite the proven effectiveness of statins in lowering cholesterol levels post-STEMI, there is a need to enhance awareness, adherence to guidelines, and efforts to achieve LDL-C targets through appropriate statin therapy.

References

Hajar R . Framingham Contribution to Cardiovascular Disease. Heart Views. 2016; 17(2):78-81. PMC: 4966216. DOI: 10.4103/1995-705X.185130. View

Curtis H, Walker A, Mackenna B, Croker R, Goldacre B . Prescription of suboptimal statin treatment regimens: a retrospective cohort study of trends and variation in English primary care. Br J Gen Pract. 2020; 70(697):e525-e533. PMC: 7357867. DOI: 10.3399/bjgp20X710873. View

Mwita J, Godman B, Esterhuizen T . Statin prescription among patients with type 2 diabetes in Botswana: findings and implications. BMC Endocr Disord. 2020; 20(1):36. PMC: 7063760. DOI: 10.1186/s12902-020-0516-7. View

OGara P, Kushner F, Ascheim D, Casey Jr D, Chung M, de Lemos J . 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2012; 61(4):e78-e140. DOI: 10.1016/j.jacc.2012.11.019. View

Wongsalap Y, Jedsadayanmata A . Trends and predictors of high-intensity statin therapy and LDL-C goal achievement among Thai patients with acute coronary syndrome. J Cardiol. 2019; 75(3):275-281. DOI: 10.1016/j.jjcc.2019.08.012. View

Collet J, Thiele H, Barbato E, Barthelemy O, Bauersachs J, Bhatt D . 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J. 2020; 42(14):1289-1367. DOI: 10.1093/eurheartj/ehaa575. View

Mahmood S, Levy D, Vasan R, Wang T . The Framingham Heart Study and the epidemiology of cardiovascular disease: a historical perspective. Lancet. 2013; 383(9921):999-1008. PMC: 4159698. DOI: 10.1016/S0140-6736(13)61752-3. View

. 10. Cardiovascular Disease and Risk Management: Standards of Medical Care in Diabetes-2022. Diabetes Care. 2021; 45(Suppl 1):S144-S174. DOI: 10.2337/dc22-S010. View

Demoz G, Wahdey S, Kasahun G, Hagazy K, Kinfe D, Tasew H . Prescribing pattern of statins for primary prevention of cardiovascular diseases in patients with type 2 diabetes: insights from Ethiopia. BMC Res Notes. 2019; 12(1):386. PMC: 6617647. DOI: 10.1186/s13104-019-4423-9. View

10.

Mohd-Zulkefli S, Omar M, Md-Redzuan A . Factors associated with lipid goal attainment among acute coronary syndrome patients. Patient Prefer Adherence. 2016; 10:1631-7. PMC: 5003558. DOI: 10.2147/PPA.S110419. View

11.

Ibanez B, James S, Agewall S, Antunes M, Bucciarelli-Ducci C, Bueno H . 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European.... Eur Heart J. 2017; 39(2):119-177. DOI: 10.1093/eurheartj/ehx393. View

12.

Sarfo F, Ovbiagele B . Prevalence and predictors of statin utilization among patient populations at high vascular risk in Ghana. J Neurol Sci. 2020; 414:116838. PMC: 7293931. DOI: 10.1016/j.jns.2020.116838. View

13.

Bibbins-Domingo K, C Grossman D, Curry S, Davidson K, Epling Jr J, Garcia F . Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2016; 316(19):1997-2007. DOI: 10.1001/jama.2016.15450. View

14.

Mortensen M, Kulenovic I, Falk E . Statin use and cardiovascular risk factors in diabetic patients developing a first myocardial infarction. Cardiovasc Diabetol. 2016; 15:81. PMC: 4882784. DOI: 10.1186/s12933-016-0400-y. View

15.

Taylor F, Huffman M, Macedo A, Moore T, Burke M, Davey Smith G . Statins for the primary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2013; (1):CD004816. PMC: 6481400. DOI: 10.1002/14651858.CD004816.pub5. View

16.

Silverio A, Benvenga R, Piscione F, Gulizia M, Meessen J, Colivicchi F . Prevalence and Predictors of Out-of-Target LDL Cholesterol 1 to 3 Years After Myocardial Infarction. A Subanalysis From the EYESHOT Post-MI Registry. J Cardiovasc Pharmacol Ther. 2020; 26(2):149-157. DOI: 10.1177/1074248420947633. View

17.

Banefelt J, Lindh M, Svensson M, Eliasson B, Tai M . Statin dose titration patterns and subsequent major cardiovascular events in very high-risk patients: estimates from Swedish population-based registry data. Eur Heart J Qual Care Clin Outcomes. 2020; 6(4):323-331. DOI: 10.1093/ehjqcco/qcaa023. View

18.

Marz W, Dippel F, Theobald K, Gorcyca K, Iorga S, Ansell D . Utilization of lipid-modifying therapy and low-density lipoprotein cholesterol goal attainment in patients at high and very-high cardiovascular risk: Real-world evidence from Germany. Atherosclerosis. 2017; 268:99-107. DOI: 10.1016/j.atherosclerosis.2017.11.020. View

19.

Mihaylova B, Emberson J, Blackwell L, Keech A, Simes J, Barnes E . The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials. Lancet. 2012; 380(9841):581-90. PMC: 3437972. DOI: 10.1016/S0140-6736(12)60367-5. View

20.

Yourman L, Cenzer I, Boscardin W, Nguyen B, Smith A, Schonberg M . Evaluation of Time to Benefit of Statins for the Primary Prevention of Cardiovascular Events in Adults Aged 50 to 75 Years: A Meta-analysis. JAMA Intern Med. 2020; 181(2):179-185. PMC: 7670393. DOI: 10.1001/jamainternmed.2020.6084. View