Assessing Changes in Statin Prescribing Patterns Surrounding the 2013 American College of Cardiology/American Heart Association Lipid Guidelines.

PURPOSE: The American College of Cardiology (ACC) and the American Heart Association (AHA) introduced new lipid guidelines in late 2013 that were a vast departure from older guidelines. Concerns were raised regarding the likely increase in the number of adults who would be eligible for lipid-lowering therapy, namely moderate to high intensity statins. We sought to determine whether, in the first year after the ACC/AHA guideline release, more patients were prescribed statins, prescribed moderate- to high-intensity statins, and eligible for statins compared with the previous year.

METHODS: This study was a retrospective, cross-sectional, observational analysis of National Ambulatory Medical Care Survey collected by the Centers for Disease Control and Prevention during the years 2013 and 2014. Survey participants who were younger than 40 years or older than 75 years, were pregnant, or had triglyceride levels ≥400 mg/dL were excluded. Descriptive analyses and χ2 tests of homogeneity (and associated odds ratios [ORs] and CIs) were constructed and reported.

FINDINGS: Compared with 2013, a higher percentage of patients in 2014 were prescribed a statin and were eligible to receive a statin. In fact, patients in 2014 were significantly more likely to be prescribed a statin (OR = 1.22; 95% CI, 1.00-1.48) and to be eligible for a statin (OR = 9.26, 95% CI 7.54-11.37) compared with 2013. Although a higher percentage of patients in 2014 were prescribed a higher-intensity statin, the difference was not statistically significant (OR = 1.17; 95% CI, 0.90-1.52).

IMPLICATIONS: In the first year after the ACC/AHA guideline introduction, more patients in the United States were prescribed a statin. However, it is unclear whether the new guidelines were strictly adhered to regarding intensity of statin therapy.