국내 성인환자에서 죽상동맥경화성 심혈관질환 위험도와 스타틴 처방 현황
Atherosclerotic Cardiovascular Disease Risk and Statin Prescription Status in Korean Adult Patients
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background: Cardiovascular (CV) disease is known as one of the major causes of death from disease worldwide. Statin therapy playsa pivotal role in atherosclerotic cardiovascular disease (ASCVD) lowering the LDL-cholesterol level effectively. The purpose of thisstudy was to evaluate the association of the intensity of statin therapy in adult patients of Korea and the risk of ASCVD of the patientgroup. Methods: We used data from sample of patients from the Health Insurance Review and Assessment Service (HIRA-NPS-2018). We analyzed the patterns of prescribing statins including types of statin, statin intensity, and number of patients with ASCVDor risk of ASCVD. Results: 155,512 patients were included in the analysis, and 27,950 patients (18.0%) was over 75 years. Highintensitystatin usage was increased in ASCVD patients compared with the low-intensity statin use. The OR (odds ratio) of highintensitystatin were increased in myocardial infarction patients compared with low-intensity statin use showing the highest OR;12.40 (95% CI; 9.48-16.22). At patient groups of angina, ischemic heart disease and carotid disease, high-intensity statin prescriptionrate was increased compared with low-intensity statin. However, there was no statistical significance between both statinprescription rates in patients of peripheral arterial disease, abdominal aneurysm, diabetic mellitus and atherosclerosis. Conclusion:The statin prescription rate showed intensity increasing tendency according to the risk of ASCVD. More aggressive statin therapymight be beneficial for the ASCVD patients based on the recent guidelines of dyslipidemia.
Abstract
Background: Cardiovascular (CV) disease is known as one of the major causes of death from disease worldwide. Statin therapy playsa pivotal role in atherosclerotic cardiovascular disease (ASCVD) lowering the LDL-cholesterol level effectively. The purpose of thisstudy was to evaluate the association of the intensity of statin therapy in adult patients of Korea and the risk of ASCVD of the patientgroup. Methods: We used data from sample of patients from the Health Insurance Review and Assessment Service (HIRA-NPS-2018). We analyzed the patterns of prescribing statins including types of statin, statin intensity, and number of patients with ASCVDor risk of ASCVD. Results: 155,512 patients were included in the analysis, and 27,950 patients (18.0%) was over 75 years. Highintensitystatin usage was increased in ASCVD patients compared with the low-intensity statin use. The OR (odds ratio) of highintensitystatin were increased in myocardial infarction patients compared with low-intensity statin use showing the highest OR;12.40 (95% CI; 9.48-16.22). At patient groups of angina, ischemic heart disease and carotid disease, high-intensity statin prescriptionrate was increased compared with low-intensity statin. However, there was no statistical significance between both statinprescription rates in patients of peripheral arterial disease, abdominal aneurysm, diabetic mellitus and atherosclerosis. Conclusion:The statin prescription rate showed intensity increasing tendency according to the risk of ASCVD. More aggressive statin therapymight be beneficial for the ASCVD patients based on the recent guidelines of dyslipidemia.
참고문헌 (20)
- Roth GA, "Global and regional patterns in cardiovascular mortality from 1990 to 2013", Circulation, 132(17), pp.1667~1678 (2015)
- de Fatima Marinho de Souza M, "Cardiovascular disease mortality in the americas : Current trends and disparities", Heart, 98(16), pp.1207~1212 (2012)
- Benjamin EJ, "Heart disease and stroke statistics-2019 update : A report from the american heart association", Circulation, 139(10), pp.e56~e528 (2019)
- Jee SH, "A coronary heart disease prediction model : the Korean Heart Study", BMJ open, 4(5), pp.e005025~ (2014)
- Montori VM, "Randomized trials stopped early for benefit : A systematic review", JAMA, 294(17), pp.2203~2209 (2005)
- Chou R, "Statins for prevention of cardiovascular disease in adults : Evidence report and systematic review for the US preventive services task force", JAMA, 316(19), pp.2008~2024 (2016)
- Shepherd J, "Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia", N Engl J Med, 333(20), pp.1301~1307 (1995)
- Istvan ES, "Structural mechanism for statin inhibition of HMG-CoA reductase", Science, 292(5519), pp.1160~1164 (2001)
- Jones PH, "Comparison of the efficacy and safety of rosuvastatin versus atorvastatin, simvastatin, and pravastatin across doses (STELLAR trial)", Am J Cardiol, 92(2), pp.152~160 (2003)
- Jones P, "Comparative dose efficacy study of atorvastatin versus simvastatin, pravastatin, lovastatin, and fluvastatin in patients with hypercholesterolemia (the CURVES study)", Am J Cardiol, 81(5), pp.582~587 (1998)
- 이은정, "2018 Guidelines for the Management of Dyslipidemia in Korea", 지질·동맥경화학회지, 8(2), pp.78~131 (2019), 한국지질동맥경화학회[DOI]
- Garber AJ, "Consensus statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the comprehensive type 2diabetes management algorithm–2018 executive summary", Endocr Pract, 24(1), pp.91~120 (2018)
- Mach F, "2019 ESC", EAS Guidelines for the management of dyslipidaemias : lipid modification to reduce cardiovascular risk, 2020, pp.41(1), 111~188
- Son KB, "Patterns of statin utilisation for new users and market dynamics in South Korea : A 13-year retrospective cohort study", BMJ open, 9(3), pp.e026603~ (2019)
- Catapano AL, "2016 ESC", EAS guidelines for the management of dyslipidaemias, 2016, pp.37(39), 2999~3058
- Kim S, "Achievement of the low-density lipoprotein cholesterol goal among patients with dyslipidemia in South Korea", PLoS One, 15(1), pp.e0228472~ (2020)
- Kwon JE, "Cholesterol lowering effects of lowdose statins in Korean patients", J lipid Atheroscler, 3(1), pp.21~28 (2014)
- Naito R, "Racial differences in the cholesterollowering effect of statin", J Atheroscler Thromb, 24(1), pp.19~25 (2017)
- "Chronic disease status and issues 2019"[URL]
- Kim HJ, "Trends in the prevalence of major cardiovascular disease risk factors among Korean adults:Results from the Korea National Health and Nutrition Examination Survey, 1998–2012", Int J Cardiol, 174(1), pp.64~72 (2014)