Sex Based Differences in Underuse of Statins

Sex-based differences in underuse of statins and antiplatelet therapy in high-risk CV patients

<h2 id="background">Background</h2><ul><li>Statins and antiplatelet agents are fundamental therapies for reducing ischemic events and mortality in patients with atherosclerotic cardiovascular disease.</li><li>Despite their proven benefits, real-world adherence remains suboptimal, and sex-based disparities may contribute to undertreatment.</li></ul><h2 id="objective">Objective</h2><ul><li>To assess adherence to statins and anti platelet therapy in adults at high or very high cardiovascular risk, with a focus on sex-based differences in treatment patterns.</li></ul><h2 id="methods">Methods</h2><ul><li>Prospective, multicenter registry across 30 cardiology centers in Argentina (April 2023-0ctober 2024) was conducted.</li><li>Eligible patients were hospitalized for cardiovascular diseases (emergency or elective) and classified as high or very high risk if they had diabetes, chronic kidney disease (creatinine clearance &lt;60 ml/min/m2), or a prior cardiovascular event.</li><li>High-intensity statin therapy was defined as atorvastatin ~40 mg or rosuvastatin ~20 mg daily.</li></ul><h2 id="results">Results</h2><ul style="list-style-type:disc;"><li>Among <strong>1,800</strong> patients (29.7% women; mean age 70.0 ±10.9years)</li><li><strong>Overall treatment received:</strong><ul><li>76.5% received anti platelet or anticoagulant therapy, 67.3% statins, 6.3% ezetimibe, and 4.1 % fibrates.</li><li>Statin use was higher in patients with prior cardiovascular interventions (77.6%).</li></ul></li><li><strong>Treatment intensity:</strong><ul><li>Only 39.7% of patients were prescribed high-intensity statins.</li></ul></li><li><strong>Sex-based differences:</strong><ul><li>Women were less likely than men to receive anti platelet therapy (p=0.018), statins (p=0.010), and high intensity statins (p&lt;0.001).</li></ul></li><li><strong>Patient perception:</strong><ul><li>Knowledge of statin benefits was limited, 41 .4% did not know their purpose, 48.4% believed they were mainly for cholesterol reduction, and only 10.2% recognized their role in reducing cardiovascular events and mortality.</li><li>Patients who rated statins as highly beneficial (~8/10) were more likely to use them (85.5% vs. 57.2%; p&lt;0.001) and to be on high-intensity therapy (50.7%vs. 33.6%; p&lt;0.001).</li><li>No significant sex differences were observed in perception of statin efficacy (p=0.435).</li></ul></li></ul><p style="text-align:center;"><img src="https://cdn.megawecare.com/GHBY/Internal-Images/image.png" alt="Pharmacological Treatments in Patients" width="1125" height="349"></p><h2 id="conclusion" data-section="conclusion">Conclusion</h2><ul><li>A substantial proportion of high-risk patients remain undertreated with statins and antiplatelet agents, with women receiving significantly less aggressive therapy than men.</li><li>These disparities highlight the need for sex-specific strategies to optimize secondary prevention.</li><li>Patient awareness of statin benefits appear to influences adherence, underscoring the importance of education to improve long-term cardiovascular outcomes.</li></ul>

Cardiology Update 2025   Issue 5 1

<ul><li><a href="#background">Background</a></li><li><a href="#objective">Objective</a></li><li><a href="#methods">Methods</a></li><li><a href="#results">Results</a></li><li><a href="#conclusion">Conclusion</a></li></ul>

Sex-based differences in underuse of statins and antiplatelet therapy in high-risk CV patients

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