AI Article Synopsis
- The study examined statin prescription rates and their impact on outcomes for atherosclerotic cardiovascular disease (ASCVD) in a large health care system, focusing on differences between Black and White patients.
- Results showed that significantly fewer Black patients were prescribed statins compared to White patients, which was linked to increased ASCVD risks for both groups, though the race interaction was not a significant factor for ASCVD events.
- Overall, the findings highlight that statins are underprescribed, and while disparities exist in prescription rates, they did not correlate directly with higher mortality risk among the studied populations.
Article Abstract
Background: Data on real-world statin prescription in large, private health care networks and impacts on primary prevention of atherosclerotic cardiovascular disease (ASCVD) outcomes across race are scarce.
Objectives: The purpose of this study was to investigate the impact of statin prescription on ASCVD outcomes within and across race in a large, nongovernmental health care system.
Methods: Statin prescription in Black and White patients without ASCVD was evaluated (2013-2019). Guideline-directed statin intensity was defined as at least "moderate" for intermediate and high-risk patients. Statin prescription at index and ASCVD outcomes at follow-up (myocardial infarction/revascularization, stroke, mortality) were assessed via electronic health care records using International Classification of Diseases-9 and 10 codes. Cox regression models, adjusted for CVD risk factors, were used to calculate HRs for association between statin prescription and incident ASCVD events across race.
Results: Among 270,079 patients, 7.6% (n = 20,477) and 92.4% (n = 249,602) identified as Black and White, respectively. Significantly fewer Black patients were prescribed statin therapy than White patients (13.6% vs 19.0%; < 0.001). At a mean follow-up of 6 years, patients with "no statin" prescription vs guideline-directed statin intensity showed increased ASCVD in Black patients (HR: 1.40 [95% CI: 1.05-1.86]), and White patients (HR: 1.32 [95% CI: 1.21-1.45]; < 0.05) and all-cause mortality. Intermediate and high-risk Black patients faced a 17% higher risk of mortality compared to White patients. However, the interaction between race and statin prescription was not a significant predictor of incident ASCVD events.
Conclusions: Statins remain underprescribed. Although Black patients received proportionally less statin prescription than White patients, this was not associated with higher risk of mortality in Black patients.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11414661 | PMC |
| http://dx.doi.org/10.1016/j.jacadv.2024.101231 | DOI Listing |
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