Retrospective cohort study of statin prescribing for primary prevention among people living with HIV

Abstract

Objective To compare statin prescribing rates between intermediate-risk people living with human immunodeficiency virus (HIV; PLWH) and intermediate-risk patients without a diagnosis of HIV for primary prevention of atherosclerotic cardiovascular disease (ASCVD). Methods Retrospective cohort study . Electronic health record data were used to identify a cohort of PLWH aged 40–75 years with a calculated 10-year ASCVD risk between 7.5%-19.9% as determined by the Pooled Cohort Equation (PCE). A matched cohort of primary prevention non-HIV patients was identified. The primary outcome was the proportion of PLWH who were prescribed statin therapy compared to patients who were not living with HIV and were prescribed statin therapy Results 81 patients meeting study criteria in the PLWH cohort were matched to 81 non-HIV patients. The proportion of patients prescribed statins was 33.0% and 30.9% in the PLWH and non-HIV cohorts, respectively (p = 0.74). Conclusion and relevance: This study evaluated statin prescribing in PLWH for primary prevention of ASCVD as described in the 2018 AHA/ACC/Multisociety guideline. Rates of statin prescribing were similar, yet overall low, among intermediate-risk primary prevention PLWH compared to those not diagnosed with HIV.

Effect of 2018 American College of Cardiology/American Heart Association Guideline Change on Statin Prescription for People Living with HIV

“…The authors reported 2.5% (95% CL: −12%, 17%) higher absolute prevalence of statin prescription among PLWH. ( Nardolillo et al, 2021 ) This study addresses a different question from our study but provides insight into potential differences in statin prescription by HIV status after guideline change.…”

“…We expanded our search to the general population and identified one study ( Tunoa et al, 2020 ) that evaluated the effect of the 2018 ACC/AHA guidelines on lipid monitoring but not statin prescription. We also identified one study ( Nardolillo et al, 2021 ) that compared statin prescriptions between PLWH and a matched cohort of people without HIV after the 2018 guideline change in a safety-net health system. The authors reported 2.5% (95% CL: −12%, 17%) higher absolute prevalence of statin prescription among PLWH.…”