Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Apr 8:18:101085.
doi: 10.1016/j.pmedr.2020.101085. eCollection 2020 Jun.

Underuse of statins for secondary prevention of atherosclerotic cardiovascular disease events among ambulatory surgical patients

Robert B Schonberger  1 , Vivek Vallurupalli  1 , Hollie Matlin  1 , Daina Blitz  1 , Adambeke Nwozuzu  1 , Brian Barron  1 , Yuemei Zhang  1 , Feng Dai  2 , Daniel Jacoby  3 , Khurram Nasir  3 , Amit Bardia  1
Affiliations

Underuse of statins for secondary prevention of atherosclerotic cardiovascular disease events among ambulatory surgical patients

Robert B Schonberger et al. Prev Med Rep. .

Abstract

Although statins are highly effective for reducing cardiovascular disease events, prior studies demonstrate their significant underuse in the US population, including among those with known atherosclerotic disease. It is unknown whether this finding applies to the subset of patients who present for outpatient surgery, as such patients would be expected to have recent exposures to healthcare providers during the preoperative referral period. The primary aim of this manuscript was to ascertain the prevalence of statin underuse and associated risk-factors for such underuse among ambulatory surgical patients with documented atherosclerotic cardiovascular disease. This was a retrospective observational study of a random sample of 600 patients ages 40-75 years presenting for ambulatory surgery within a 6-month period in 2016, at one of three ambulatory surgical centers affiliated with a large, tertiary care hospital. Compilation and analysis of data occurred in 2018-2019. Of the 600 subjects, 117 (19.5%) had documented atherosclerotic cardiovascular disease. Within this high-risk group, only 71 (60.7%) carried a prescription for any statin, and only 30 (25.6%) were prescribed a recommended high intensity statin dose for secondary prevention. In a multivariable logistic regression analysis, older age, male sex, and treatment for hypertension were positively associated with statin use. In conclusion, statin underuse among ambulatory surgical patients is common and mirrors what has been observed in non-surgical populations. Future trials are needed to investigate the possible role of surgical teams to promote guideline-based statin therapy, including the role of preoperative screening interventions to impact long term cardiovascular morbidity and mortality.

Keywords: Hydroxymethylglutaryl-CoA reductase inhibitors; Perioperative care; Preventive medicine.

PubMed Disclaimer

References

    1. Cullen, K., Hall, M., 2009. Golosinskiy A: Ambulatory Surgery in the United States, 2006 (Revised January 28, 2009). National Health Statistics Reports 2009. p. 11. - PubMed
    1. Dripps R.D., Lamont A., Eckenhoff J.E. The role of anesthesia in surgical mortality. JAMA. 1961;178:261–266. - PubMed
    1. Kheterpal S. Clinical research using an information system: the multicenter perioperative outcomes group. Anesthesiol. Clin. 2011;29:377–388. - PubMed
    1. Larach M.G., Klumpner T.T., Brandom B.W., Vaughn M.T., Belani K.G., Herlich A., Kim T.W., Limoncelli J., Riazi S., Sivak E.L., Capacchione J., Mashman D., Kheterpal S., Kooij F., Wilczak J., Soto R., Berris J., Price Z., Lins S., Coles P., Harris J.M., Cummings K.C., 3rd, Berman M.F., Nanamori M., Adelman B.T., Wedeven C., LaGorio J., McCormick P.J., Tom S., Aziz M.F., Coffman T., Ellis T.A., 2nd, Molina S., Peterson W., Mackey S.C., van Klei W.A., Ginde A.A., Biggs D.A., Neuman M.D., Craft R.M., Pace N.L., Paganelli W.C., Durieux M.E., Nair B.J., Wanderer J.P., Miller S.A., Helsten D.L., Turnbull Z.A., Schonberger R.B. Succinylcholine use and dantrolene availability for malignant hyperthermia treatment: database analyses and systematic review. Anesthesiology. 2019;130:41–54. - PubMed
    1. Lee L.O., Bateman B.T., Kheterpal S., Klumpner T.T., Housey M., Aziz M.F., Hand K.W., MacEachern M., Goodier C.G., Bernstein J., Bauer M.E. Risk of epidural hematoma after neuraxial techniques in thrombocytopenic parturients: a report from the multicenter perioperative outcomes group. Anesthesiology. 2017;126:1053–1063. - PMC - PubMed

LinkOut - more resources