Prevalence and Predictors of Statin Treatment Among Patients With Chronic Heart Failure at a Tertiary-Care Center in Thailand

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.

Impact of Statin Therapy in Heart Failure Patients

“…We have confirmed a high percentage of statin prescriptions in HF patients treated within Intermountain Healthcare, similar to other reports. 17 Given this, we are reassured by confirmation of: 1) a lack of a safety signal; and 2) a strong benefit signal in our observational study. Thus, we did not find evidence to recommend changes to the current practice pattern with respect to statin prescription in HF patients.…”

“… 12 Furthermore, in clinical practice, treatment with statins continues to be common, that is, reported to be one-half or more of HF patients. 17 …”

Perilla seed oil as an adjunctive treatment with statins improves lipid profiles in elderly patients: a post hoc data analysis

“…However, it is noteworthy that a segment of patients might require supplementary pharmacological interventions to achieve their LDL-C targets [5]. Additionally certain patients might exhibit intolerance to statins, manifested in side effects such as myopathy and hepatotoxicity [6]. Consequently, it is imperative to understand that statins might not universally satisfy all dyslipidemia patients' needs.…”