Early initiation of lipid-lowering therapy for acute coronary syndromes improves compliance with guideline recommendations: observations from the Orbofiban in Patients with Unstable Coronary Syndromes (OPUS-TIMI 16) trial.

Abstract

BACKGROUND:

Lipid-lowering is effective in the prevention of cardiovascular morbidity and mortality in patients with coronary artery disease, but effective strategies for improving the implementation of these therapies are needed.

METHODS:

In the 10,288 patients in the OPUS-TIMI 16 trial, patients were stratified by use of lipid-lowering therapy during index hospitalization and were compared for use of lipid-lowering therapy at follow-up as well as for clinical outcomes.

RESULTS:

Lipid-lowering therapy was used in 38% of patients during the index hospitalization, of which 94% were statins. At 10 months, 88% of patients who were discharged on lipid-lowering medications remained on these drugs. Conversely, only 34% of patients not discharged on lipid-lowering medications were receiving them at 10 months. Forty-one percent of patients with prior history of hyperlipidemia requiring treatment were not discharged on lipid-lowering therapy, and of these, only 51% were subsequently started on a lipid-lowering medication as an outpatient despite clear indications. Patients treated as inpatients with lipid-lowering therapy had a lower mortality rate at 10 months adjusted by propensity analysis (3.1% vs 5.1%, P < .0001) than patients not treated with lipid-lowering therapy.

CONCLUSION:

In patients with acute coronary syndromes, the initiation of lipid-lowering therapy in the inpatient setting increases the rate of its subsequent use at 10 months, making this an important method of ensuring appropriate secondary prevention.

• Authors: Charles S Smith, Christopher P Cannon, Carolyn H McCabe, Sabina A Murphy, Jane Bentley, Eugene Braunwald
• Journal: American heart journal (Am Heart J) Vol. 149 Issue 3 Pg. 444-50 (Mar 2005) ISSN: 1097-6744 [Electronic] United States
• PMID: 15864232 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Hydroxymethylglutaryl-CoA Reductase Inhibitors

Topics

• Acute Disease
• Aged
• Coronary Disease (complications, mortality, therapy)
• Female
• Follow-Up Studies
• Guideline Adherence
• Heart Failure (complications, diagnosis)
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (administration & dosage)
• Hyperlipidemias (complications, prevention & control)
• Male
• Middle Aged
• Patient Compliance
• Survival Rate
• Syndrome