Methods: This is a comparative, retrospective study reviewing patients eligible for a statin that had an encounter between February 1, 2017 and September 30, 2017 at two outpatient clinics within an urban, academic medical system. Patients that qualified for one of the following statin benefit groups were included: clinical atherosclerotic cardiovascular disease (ASCVD), low density lipoprotein cholesterol (LDL-C) ≥ 190 mg/dL, or diabetes with LDL-C 70-189 mg/dL between 40 and 75 years old. Patients less than 21 years old or without a lipid panel within the last 3 years were excluded. The primary outcome was the percentage of patients with HIV prescribed a statin compared to uninfected patients. Subanalyses assessed the statin gap in individual benefit groups and statin intensity distribution. Predictors associated with receiving a statin were analyzed using a logistic regression model.
Results: A total of 501 HIV-positive and 1625 HIV-negative patients met the study criteria. There was no statistical difference in statin prescribing rates for patients with HIV (60.7%) and those without (65.7%, OR 1.24 [0.86-1.78]). Patients with active smoking status (OR 1.28 [1.01-1.62]) or smoking history (OR 1.47 [1.17-1.84]), and older age (OR 1.05 [1.03-1.06]) were more likely to be prescribed a statin. No association was observed between prescribed statin and HIV status in each of the benefit groups. HIV patients more often received a medium intensity statin (OR 1.10 [0.52-2.32]), whereas uninfected patients more often received a high intensity statin (OR 0.43 [0.20-0.90]).
Conclusion: No difference in statin prescribing rates was observed in HIV versus uninfected patients. This demonstrates the statin gap is pertinent regardless of HIV status and additional analysis is needed to investigate reasons for the gap in both populations.
K. Pincus, None
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