Abstract 16957

Background: Guidelines recommend the use of statins for patients with atherosclerotic cardiovascular disease (ASCVD) or diabetes mellitus (DM), leading causes of morbidity, mortality, and resource utilization. To characterize real world treatment patterns in these populations, we identified prescriptions for lipid lowering therapy (LLT) before and after an ASCVD or DM diagnosis.

Methods: Using electronic algorithms in the Rochester Epidemiology Project, we identified Olmsted County, MN residents (age ≥18 years) diagnosed with DM or ASCVD (myocardial infarction, unstable angina, revascularization, ischemic stroke/transient ischemic attack) from 2005-2012 (index event). Prescriptions for LLT were obtained and characterized within the 3 months prior to and after the index event.

Results: A total of 8338 patients with DM (n=4839) or ASCVD (n=3499) were identified (mean age 63.1 years, 55.2% male). Patients with DM were younger (58.1 vs. 69.8 years, p<0.001) and less likely to be male (53.9% vs. 56.8%, p=0.008) than those with ASCVD. Prior to the index event, 38.3% and 40.8% of patients with DM and ASCVD, respectively, were prescribed LLT (Table). This increased to 47.7% (DM) and 72.8% (ASCVD) by 3 months after diagnosis. The majority of patients on LLT were prescribed statins of moderate potency. High-potency statin prescriptions (alone or in combination with other LLT) were infrequent for DM patients and changed little after diagnosis. In contrast, prescriptions for high-potency statins nearly tripled after ASCVD diagnosis, from 6.4% to 17.0%.

Conclusions: Statin prescriptions increased 30-50% immediately after DM or ASCVD diagnosis; however, high-potency statins were infrequently prescribed, even for patients with ASCVD. These data capture a time period before the 2013 ACC/AHA guidelines; re-evaluating LLT prescribing patterns in the post-guideline period is needed to evaluate potential shifts and to identify where the burden of unmet need is greatest.