title: [Clinical-Epidemiological Profile of Patients Initiating Intensive Statin Therapy for the Secondary Prevention of Vascular Disease in Spain].
abstract: BACKGROUND
  The new recommendations regarding the utilization of high potency statins (intensive therapy) for the treatment of cardiovascular disease have been based on the extrapolation of data coming from clinical trials. The objective is to describe the clinical-epidemiological profile of statin therapy users for the secondary prevention of cardiovascular disease in Spain and to examine the predictors for intensive therapy initiation.
  
  
  METHODS
  Cross-sectional study from a sample of 88,751 patients aged ≥45 years-old with previous cardiovascular disease which initiated statin therapy between 1st January 2007 to 31st December 2011. Dose treatments >40 mg simvastatin daily (or equivalent dose if different statin) were considered intensive therapy treatment. Multivariable logistic regression models were built for dependent summary variables to examine the association between and the intensive therapy utilization (vs low-moderate intensity therapy).
  
  
  RESULTS
  16,857 adult patients receiving a first prescription of statin for the secondary prevention of cardiovascular diseases were identified. Predictors for intensive therapy initiation were year of statin prescription, male gender (adjusted OR: 1.70; 95% CI: 1.44-2.00), age >75 years-old (1.39; 1.15-1.69), previous history of coronary artery disease (1.71; 1.44-2.04), previous history of transient ischemic attack (1.24; 0,97-1.59), smoking (1.62; 1.34-1.95), hypertension (1.41; 1.20-1.65) and recent use of fibrates (2.32; 1.27-4.26).
  
  
  CONCLUSIONS
  The onset of intensive therapy with statins in secondary was determined by the type of vascular event and age (>75 years-old in which the risk benefit balance could be controversial). No statistically significant differences were found according to the LDL-c levels.
authors.forename: Diego
authors.initials: D
authors.lastname: Macías Saint-Gerons
authors.forename: César
authors.initials: C
authors.lastname: de la Fuente Honrubia
authors.forename: Diana
authors.initials: D
authors.lastname: González Bermejo
authors.forename: Dolores
authors.initials: D
authors.lastname: Montero
authors.forename: Miguel J
authors.initials: MJ
authors.lastname: Gil
authors.forename: Antonio
authors.initials: A
authors.lastname: Salvador Sanz
authors.forename: Fernando
authors.initials: F
authors.lastname: de Andrés-Trelles
authors.forename: Ferrán
authors.initials: F
authors.lastname: Catalá-López
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017891:Pharmacoepidemiology; D055502:Secondary Prevention; D012737:Sex Factors; D019821:Simvastatin / Q000627:therapeutic use*; D013030:Spain / Q000453:epidemiology
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D019821:Simvastatin