Elderly Patients with CHD: Trends in Dyslipidemia Treatment
(HealthDay News) — High numbers of elderly patients with coronary heart disease (CHD) are not being treated with a statin, according to a study published in the October 27 issue of the Journal of the American College of Cardiology.
Vera Bittner, MD, MSPH, from the University of Alabama at Birmingham, and colleagues evaluated trends between 2007–2011 for statin and non-statin lipid-lowering therapy (niacin, fibrates, bile acid sequestrants, and ezetimibe) use among Medicare beneficiaries with CHD. A random, national sample of 5% of Medicare beneficiaries (310,091 participants) was used to create 20 cohorts, representing calendar quarters.
The researchers found that statin use increased from 53.1 to 58.8% between 2007–2011. Ezetimibe use declined from its peak of 18.4% in statin users and 5.0% in non-statin users to 6.2 and 2.4%, respectively, by the end of 2011. Over the study period, fibrate use increased from 4.2 to 5.0%, bile acid sequestrants did not change significantly, and niacin use increased initially from 1.5 to 2.4% and then declined in late 2011. Among those of older age, African-Americans, patients with heart failure, and patients with a higher Charlson comorbidity score, use of non-statin lipid-lowering therapy was less common, while it was more common among men and patients with diabetes, those who had cardiologist visits, and those taking statins.
"Declining ezetimibe and niacin use but not fibrate therapy among Medicare beneficiaries with CHD coincides with negative clinical trial results for these agents," the authors write.
Several authors disclosed financial ties to pharmaceutical companies, including Amgen, which funded the study.