Key result
Prior use of high-intensity statins or being statin-naïve increased the likelihood of discharge on appropriate statin therapy compared to low/moderate-intensity statins (80.4% vs 50.9%; OR 3.41).
Why the study?
Statins are the mainstay of therapy after acute ischemic stroke or myocardial infarction, but prior studies indicate prescribing remains suboptimal.
What percentage of patients newly diagnosed with AIS or MI are prescribed appropriate statin therapy upon discharge?
Cohort (n=247)
No
What percentage of patients newly diagnosed with AIS or MI are prescribed appropriate statin therapy upon discharge?
A significant proportion of patients with newly diagnosed AIS or MI are not prescribed appropriate statin therapy at discharge, particularly those previously on low or moderate-intensity statins.
Suboptimal statin prescribing at discharge after AIS or MI may persist; leaves open targeted quality improvement and larger prospective studies.
BACKGROUND: Statins are the mainstay of therapy in patients suffering an acute ischemic stroke (AIS) or myocardial infarction (MI); however, several studies have shown that prescribing is not optimal. OBJECTIVE: The main objective of this study was to evaluate the percentage of patients prescribed appropriate statin therapy upon discharge after an AIS or MI. METHODS: This is a single-center retrospective cohort study conducted at a tertiary, county, teaching hospital in patients aged 18 to 89 years who were newly diagnosed with AIS or MI, from September 2017 to September 2022. RESULTS: Six hundred thirty-six individuals were hospitalized for AIS or MI according to ICD-10 codes. Of these, 389 patients were excluded, and 247 were included in the analysis. Although 85% of AIS and MI patients were at very high risk of future ASCVD events, over 25% were not discharged on appropriate statin therapy. Patients who had been taking high-intensity statins or were statin-naïve prior to admission (156/194, 80.4%) were significantly more likely to be discharged with appropriate statin therapy compared to those who had been taking low or moderate-intensity statins at home (27/53, 50.9%, p<0.0001, OR = 3.41, 95% CI = 1.71 to 6.79). CONCLUSION AND RELEVANCE: The treatment of patients with statin therapy following an AIS and MI remains suboptimal, despite most of these patients being at very high risk for further ASCVD events. Significantly more patients on high-intensity statins or were statin naïve on admission were discharged on appropriate therapy.
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Charles F. Seifert (2025) conducted a cohort in Acute ischemic stroke or myocardial infarction (n=247). High-intensity statins or statin-naïve prior to admission vs. Low or moderate-intensity statins prior to admission was evaluated on Discharged with appropriate statin therapy (OR 3.41, 95% CI 1.71 to 6.79, p=<0.0001). Prior use of high-intensity statins or being statin-naïve increased the likelihood of discharge on appropriate statin therapy compared to low/moderate-intensity statins (80.4% vs 50.9%; OR 3.41).
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