title: Low statin use in adults hospitalized with acute coronary syndrome.
abstract: OBJECTIVE
  To assess recommended and actual use of statins in primary prevention of cardiovascular disease (CVD) based on clinical prediction scores in adults who develop their first acute coronary syndrome (ACS).
  
  
  METHODS
  Cross-sectional study of 3172 adults without previous CVD hospitalized with ACS at 4 university centers in Switzerland. The number of participants eligible for statins before hospitalization was estimated based on the European Society of Cardiology (ESC) guidelines and compared to the observed number of participants on statins at hospital entry.
  
  
  RESULTS
  Overall, 1171 (37%) participants were classified as high-risk (10-year risk of cardiovascular mortality ≥5% or diabetes); 1025 (32%) as intermediate risk (10-year risk <5% but ≥1%); and 976 (31%) as low risk (10-year risk <1%). Before hospitalization, 516 (16%) were on statins; among high-risk participants, only 236 of 1171 (20%) were on statins. If ESC primary prevention guidelines had been fully implemented, an additional 845 high-risk adults (27% of the whole sample) would have been eligible for statins before hospitalization.
  
  
  CONCLUSIONS
  Although statins are recommended for primary prevention in high-risk adults, only one-fifth of them are on statins when hospitalized for a first ACS.
authors.affiliation: Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland. Electronic address: Kevin.selby@hospvd.ch.
authors.forename: Kevin
authors.initials: K
authors.lastname: Selby
authors.affiliation: Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland.
authors.forename: David
authors.initials: D
authors.lastname: Nanchen
authors.affiliation: Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland.
authors.forename: Reto
authors.initials: R
authors.lastname: Auer
authors.affiliation: Division of Cardiology, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland.
authors.forename: Baris
authors.initials: B
authors.lastname: Gencer
authors.affiliation: Department of Cardiology, University Hospital Bern, Bern, Switzerland.
authors.forename: Lorenz
authors.initials: L
authors.lastname: Räber
authors.affiliation: Department of Cardiology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Roland
authors.initials: R
authors.lastname: Klingenberg
authors.affiliation: Department of General Internal Medicine, University Hospital of Bern, Bern, Switzerland.
authors.forename: Manuel
authors.initials: M
authors.lastname: Blum
authors.affiliation: Department of Internal Medicine, Internal Medicine, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Pedro
authors.initials: P
authors.lastname: Marques-Vidal
authors.affiliation: Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland.
authors.forename: Jacques
authors.initials: J
authors.lastname: Cornuz
authors.affiliation: Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Olivier
authors.initials: O
authors.lastname: Muller
authors.affiliation: Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland.
authors.forename: Pierre
authors.initials: P
authors.lastname: Vogt
authors.affiliation: Institute of Social and Preventive Medicine and Clinical Trials Unit, Department of Clinical Research, University of Bern, Bern, Switzerland.
authors.forename: Peter
authors.initials: P
authors.lastname: Jüni
authors.affiliation: Department of Cardiology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Christian M
authors.initials: CM
authors.lastname: Matter
authors.affiliation: Department of Cardiology, University Hospital Bern, Bern, Switzerland.
authors.forename: Stephan
authors.initials: S
authors.lastname: Windecker
authors.affiliation: Department of Cardiology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Lüscher
authors.affiliation: Department of Cardiology, University Hospital Bern, Bern, Switzerland.
authors.forename: François
authors.initials: F
authors.lastname: Mach
authors.affiliation: Department of General Internal Medicine, University Hospital of Bern, Bern, Switzerland.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Rodondi
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000517:prevention & control; D003430:Cross-Sectional Studies; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013557:Switzerland
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Acute coronary syndrome; Cardiovascular risk scores; Primary prevention; Statins