Statin use before AMI was low: only 34% with ≥3 risk factors and 20% at very high SCORE2 risk received statins, with no improvement from 2005 to 2015.
A large proportion of patients presenting with a first AMI who had multiple risk factors or very high SCORE2 risk were not receiving guideline-recommended primary prevention with statins.
Tasa de eventos absoluta: 0% vs 0%
Abstract Background primary prevention has led to a decrease in the incidence of acute myocardial infarction (AMI). Many patients with risk factors, however, may be poorly managed. Aim using the FAST-MI 2005-2015 nationwide French registries of AMI, we analysed treatment patterns in patients admitted for AMI and with no previously known atherosclerotic cardiovascular disease, according to their risk factors (RF) and SCORE2 risk levels. Methods Among 13,130 patients hospitalised for AMI (STEMI or NSTEMI), 8,665 had no history of atherosclerotic CV disease (mean age 63.5 years, men 71%, STEMI 60%). Chronic statin use before the event was analysed according to number of previously known RF and a surrogate of the SCORE2 very high risk. Results Statin use was recorded in 2%, 6.5%, 18.5% and 34% of the patients with 0,1,2 and ≥3 RF. Statin use did not differ according to gender and increased according to age (Figure). In the 5,236 patients who used ≥1 CV or non-CV medication before AMI (i.e. patients with chronic medical follow-up), statin use ranged from 6% (no RF) to 43% (≥3 RF). In those who had both diabetes and hypertension, 33% had received statins. In patients at very high SCORE2 risk, statins were used in 20% vs 12% in patients at low/high risk. In the 6,010 patients with LDL-c measured at admission, 66% of those at very high risk had LDL-c 100 mg/dl. Finally, no change in statin prescription before AMI was observed from 2005 to 2015, from 15% to 16% for the whole population, and from 34% to 33% in those with ≥ 3 RF. Conclusion in patients with no previously known atherosclerotic cardiovascular disease who sustained an AMI, statin prescription was notably insufficient when considering their risk profile: two-thirds of the patients with ≥ 3 RF and 4 out of 5 patients with a very high risk SCORE2 did not receive statin therapy. No improvement was noted over the 10-year period of the surveys. Primary prevention in patients at risk definitely needs to improve.
Ferrieres et al. (Sat,) reported a other. Statin use before AMI was low: only 34% with ≥3 risk factors and 20% at very high SCORE2 risk received statins, with no improvement from 2005 to 2015.