The use of, factors associated with, and long-term outcomes related to
statin therapy in patients with
acute coronary syndromes and
low-density lipoprotein (
LDL) levels<100 mg/dl at the time of hospital presentation are unclear. This report describes the use of
statins at hospital discharge in 8,492 patients with
acute coronary syndromes enrolled in the Global Registry of Acute Coronary Events (GRACE; 1999 to 2005) according to baseline
LDL levels (<100 vs>or=100 mg/dl) and compares 6-month outcomes in each group stratified by the use or nonuse of
statin therapy. Seventy-two percent of patients with
LDL levels>or=100 mg/dl, compared with 55% of patients with
LDL levels<100 mg/dl, were discharged on
statin therapy. Sociodemographic, clinical, and treatment variables varied between patients discharged on
statins and those who were not. Patients receiving
statins at discharge were twofold (
LDL>or=100 mg/dl) to threefold (<100 mg/dl) more likely to be receiving
statin therapy at 6 months compared with those not receiving
statins at discharge.
Statin use at discharge was associated with a significantly lower rate of 6-month cardiac complications in patients with
LDL levels<100 mg/dl (adjusted odds ratio for the composite end point of
myocardial infarction,
stroke, and death 0.64, 95% confidence interval 0.47 to 0.88). In conclusion, data from this large observational study suggest that patients with
acute coronary syndromes and
LDL levels<100 mg/dl are much less likely to be prescribed
statin therapy at hospital discharge or to be receiving
statin therapy at 6 months but benefit from the prescription of
statins at hospital discharge as much as patients with levels>or=100 mg/dl.