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Comparing rates of statin therapy in eligible patients living with HIV versus uninfected patients
Author(s) -
Blackman AL,
Pandit NS,
Pincus KJ
Publication year - 2020
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/hiv.12794
Subject(s) - medicine , statin , confidence interval , atherosclerotic cardiovascular disease , odds ratio , logistic regression , diabetes mellitus , human immunodeficiency virus (hiv) , retrospective cohort study , disease , family medicine , endocrinology
Objectives Despite an increased risk of atherosclerotic cardiovascular disease ( ASCVD ) in people living with HIV ( PLWH ), a gap in statin prescribing practices has been described for statin‐eligble PLWH and uninfected patients. Few data have become available characterizing this gap since the publication of the 2013 American College of Cardiology/American Heart Association lipid guidelines. The objective of this study was to characterize statin prescribing rates for eligible PLWH compared to uninfected adults. Methods This was a retrospective, comparative analysis of patients seen at two clinics in an urban, academic medical system between February 2017 and September 2017. Patients who qualified for one of the statin benefit groups were included: those with a history of clinical ASCVD , low‐density lipoprotein cholesterol ≥ 190 mg/dL, diabetes mellitus, or 10‐year ASCVD risk score ≥ 7.5%. Patients < 21 years old or without a lipid panel within 3 years were excluded. The primary outcome was the percentage of PLWH prescribed a statin compared to uninfected patients. Predictors associated with receiving a statin were analysed using a logistic regression model. Results Nine hundred and eight PLWH and 2239 uninfected patients met the study criteria. A difference in statin prescribing rates was observed between PLWH and uninfected patients (44% versus 56%, respectively; adjusted odds ratio (OR) 0.79; 95% confidence interval (CI) 0.66–0.94). However, only in the 10‐year ASCVD risk group were the rates significantly different (24% for PLWH versus 36% for uninfected patients; adjusted OR 0.68; 95% CI 0.5–0.92). PLWH more often received a medium‐intensity statin and uninfected patients more often received a high‐intensity statin. Conclusions PLWH with ASCVD risk were less likely to be prescribed a statin compared to uninfected patients. Additional analyses are needed to investigate reasons for the statin prescribing gap and appropriateness of lipid agent selection in both study populations.