PLWH at a disadvantage in receiving statin therapy for ASCVD risk reduction

People living with HIV (PLWH) are less likely to receive appropriate statin therapy for the prevention of atherosclerotic cardiovascular disease (ASCVD), a study has found.

“This is important given the heightened risk for ASCVD in this population, and strategies that address this gap in care should be explored,” the investigators said.

This retrospective study sought to assess statin eligibility and prescribing patterns among patients in both an HIV and internal medicine clinic at an urban, academic medical centre from June to September 2018 using the American College of Cardiology/American Heart Association guideline on treating blood cholesterol to reduce ASCVD risk.

The investigators evaluated patients for eligibility and actual treatment with appropriate statin therapy. They also compared the characteristics of patients who were appropriately and not appropriately treated using chi-square testing; predictors for receiving appropriate statin therapy were uncovered using logistic regression.

Of the 300 participants included in the analysis, 221 were statin-eligible. Of note, there were fewer statin-eligible PLWH receiving the current statin intensity for their risk benefit group relative to the uninfected control group (30.2 percent vs 67.0 percent; p<0.001).

Multivariate analyses revealed that PLWH were significantly at a disadvantage in terms of receiving appropriate statin therapy. On the other hand, those with polypharmacy were more likely to receive the appropriate treatment.

“Recent studies suggest that statins are underprescribed in PLWH at risk for ASCVD, but none have assessed if eligible patients receive the correct statin and intensity compared to uninfected controls,” the investigators noted.