title: Current statin usage for patients with acute coronary syndrome undergoing percutaneous coronary intervention: multicenter survey in Korea.
abstract: BACKGROUND
  Although high-dose statin therapy has been reported to improve outcomes in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI), patterns of statin usage for such patients have not been reported in real-world clinical practice.
  
  
  OBJECTIVE
  Some clinical factors would affect the pattern of statin usage in patients with ACS.
  
  
  METHODS
  In the multicenter prospective registry, 3362 patients with ACS who underwent PCI were analyzed. High-dose statin treatment was defined as atorvastatin ≥40 mg or rosuvastatin ≥20 mg per day. The patterns of statin usage were investigated for 30 days after the index PCI.
  
  
  RESULTS
  High-dose statins were administered prior to PCI to 13.7% and 19.6% of patients with unstable angina/non-ST-elevated myocardial infarction (UA/NSTEMI) and ST-elevated myocardial infarction (STEMI), respectively (P < 0.001). After PCI, 476 (14.2%) patients were maintained on high-dose statins, and 550 (16.4%) patients received no statins. Independent factors associated with high-dose statin usage after PCI were STEMI (odds ratio [OR]: 1.704, 95% confidence interval [CI]: 1.321-2.197, P < 0.001), high total cholesterol level (OR: 1.445, 95% CI: 1.136-1.837, P = 0.003), and current smoker (OR: 1.556, 95% CI: 1.206-2.008, P < 0.011). The absence of hypercholesterolemia was an independent factor determining the nonuse of statins (OR: 0.229, 95% CI: 0.148-0.353, P < 0.001).
  
  
  CONCLUSIONS
  In real-world clinical practice, high-dose statin treatment is being underused despite extensive evidence for patients with ACS undergoing PCI, particularly in UA/NSTEMI. Efforts are needed to ensure that clinical practice complies with evidence-based guidelines.
authors: Cardiovascular Center, Incheon St. Mary's Hospital, The Catholic University, Incheon, Republic of Korea.
authors: Mi-Jeong
authors: MJ
authors: Kim
authors: Doo Soo
authors: DS
authors: Jeon
authors: Hyeon-Cheol
authors: HC
authors: Gwon
authors: Soo-Joong
authors: SJ
authors: Kim
authors: Kiyuk
authors: K
authors: Chang
authors: Hyo-Soo
authors: HS
authors: Kim
authors: Seung-Jea
authors: SJ
authors: Tahk
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy / Q000628:therapy*; D000368:Aged; D000069059:Atorvastatin; D016009:Chi-Square Distribution; D004363:Drug Utilization; D017723:Drug Utilization Review; D019317:Evidence-Based Medicine; D005260:Female; D005464:Fluorobenzenes / Q000008:administration & dosage*; D019983:Guideline Adherence; D019538:Health Care Surveys; D006538:Heptanoic Acids / Q000008:administration & dosage*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011446:Prospective Studies; D011743:Pyrimidines / Q000008:administration & dosage*; D011758:Pyrroles / Q000008:administration & dosage*; D012042:Registries; D056910:Republic of Korea; D012307:Risk Factors; D000068718:Rosuvastatin Calcium; D013449:Sulfonamides / Q000008:administration & dosage*; D013997:Time Factors
chemical_list: D005464:Fluorobenzenes; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011743:Pyrimidines; D011758:Pyrroles; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium; D000069059:Atorvastatin