Skip Navigation


European Heart Journal Advance Access originally published online on December 7, 2006
European Heart Journal 2007 28(2):154-159; doi:10.1093/eurheartj/ehl391
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
28/2/154    most recent
ehl391v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Penning-van Beest, F. J.A.
Right arrow Articles by Herings, R. M.C.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Penning-van Beest, F. J.A.
Right arrow Articles by Herings, R. M.C.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The European Society of Cardiology 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Adherence to evidence-based statin guidelines reduces the risk of hospitalizations for acute myocardial infarction by 40%: a cohort study

Fernie J.A. Penning-van Beest1,*, Fabian Termorshuizen1, Wim G. Goettsch1, Olaf H. Klungel2, John J.P. Kastelein3 and Ron M.C. Herings1,2

1 PHARMO Institute, PO Box 85222, 3508 AE Utrecht, The Netherlands
2 Utrecht Institute of Pharmaceutical Sciences, Utrecht, The Netherlands
3 Academic Hospital Amsterdam, Amsterdam, The Netherlands

Received 10 February 2006; revised 1 September 2006; accepted 3 November 2006; online publish-ahead-of-print 7 December 2006.

* Corresponding author. Tel: +31 30 2345162; fax: +31 30 2345568. E-mail address: fernie.penning{at}pharmo.nl

Aims To investigate the ‘real world’ effectiveness of robust statin therapy, focusing on the effect of dose and early treatment discontinuation on the risk of hospitalization for acute myocardial infarction (AMI).

Methods and results In the PHARMO database, including among others drug-dispensing and hospital discharge records for more than two million subjects in the Netherlands, 59 094 new users of statins in the period 1 January 1991 until 31 December 2004, ≥ 18 years of age were identified. In these patients, exposure to statins, both in terms of persistence and dose, was determined over the first two treatment years. To determine the risk for AMI, patients were followed from this 2-year time point until the first hospital admission for AMI, death, or end of the study period. A total of 31 557 patients (53%) discontinued statin use within 2 years; 20 883 patients (35%) were persistent users with an average equipotent dose ≥ 4. A 30% reduction in risk of hospitalization for AMI with persistent statin use was observed. The protective effect increased with a higher dose (20 and 40% risk reduction with an equipotent dose ≤ 3 and ≥ 4, respectively).

Conclusion These results show that statins are suboptimally used in real life for having the maximum benefit in terms of preventing AMI.

Key Words: Statins • Persistence • Dose • Acute myocardial infarction • Daily practice • Effectiveness


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer:
Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.