Campbell University College of Pharmacy & Health Sciences, Buies Creek, NC, USA; Harnett Health System, Lillington, NC, USA.
Campbell University College of Pharmacy & Health Sciences, Buies Creek, NC, USA.
Clin Ther. 2019 Feb;41(2):314-321. doi: 10.1016/j.clinthera.2018.12.017. Epub 2019 Jan 25.
The American College of Cardiology (ACC) and the American Heart Association (AHA) introduced new lipid guidelines in late 2013 that were a vast departure from older guidelines. Concerns were raised regarding the likely increase in the number of adults who would be eligible for lipid-lowering therapy, namely moderate to high intensity statins. We sought to determine whether, in the first year after the ACC/AHA guideline release, more patients were prescribed statins, prescribed moderate- to high-intensity statins, and eligible for statins compared with the previous year.
This study was a retrospective, cross-sectional, observational analysis of National Ambulatory Medical Care Survey collected by the Centers for Disease Control and Prevention during the years 2013 and 2014. Survey participants who were younger than 40 years or older than 75 years, were pregnant, or had triglyceride levels ≥400 mg/dL were excluded. Descriptive analyses and χ tests of homogeneity (and associated odds ratios [ORs] and CIs) were constructed and reported.
Compared with 2013, a higher percentage of patients in 2014 were prescribed a statin and were eligible to receive a statin. In fact, patients in 2014 were significantly more likely to be prescribed a statin (OR = 1.22; 95% CI, 1.00-1.48) and to be eligible for a statin (OR = 9.26, 95% CI 7.54-11.37) compared with 2013. Although a higher percentage of patients in 2014 were prescribed a higher-intensity statin, the difference was not statistically significant (OR = 1.17; 95% CI, 0.90-1.52).
In the first year after the ACC/AHA guideline introduction, more patients in the United States were prescribed a statin. However, it is unclear whether the new guidelines were strictly adhered to regarding intensity of statin therapy.
美国心脏病学会（ACC）和美国心脏协会（AHA）于 2013 年末发布了新的血脂指南，与旧指南相比有了很大的改变。人们担心接受降脂治疗的成年人数量会增加，即中高强度他汀类药物。我们旨在确定在 ACC/AHA 指南发布后的第一年，与前一年相比，是否有更多的患者接受了他汀类药物治疗、中高强度他汀类药物治疗以及有资格接受他汀类药物治疗。
本研究是对疾病控制与预防中心在 2013 年和 2014 年收集的全国门诊医疗保健调查的回顾性、横断面、观察性分析。排除年龄小于 40 岁或大于 75 岁、怀孕或三酰甘油水平≥400mg/dL 的调查参与者。构建并报告描述性分析和同质性 χ 检验（以及相关的比值比[OR]和置信区间[CI]）。
与 2013 年相比，2014 年接受他汀类药物治疗的患者比例和有资格接受他汀类药物治疗的患者比例均较高。事实上，与 2013 年相比，2014 年患者接受他汀类药物治疗的可能性显著更高（OR=1.22；95%CI，1.00-1.48），有资格接受他汀类药物治疗的可能性更高（OR=9.26，95%CI 7.54-11.37）。尽管 2014 年接受高强度他汀类药物治疗的患者比例较高，但差异无统计学意义（OR=1.17；95%CI，0.90-1.52）。
在 ACC/AHA 指南发布后的第一年，美国有更多的患者接受了他汀类药物治疗。然而，尚不清楚新指南在他汀类药物治疗强度方面是否得到严格遵守。
