{
  "abstract": "High intensity statin (HIS) therapy is recommended for all patients with cardiovascular disease (CVD). Many patients receive sub-optimal lipid lowering therapy (LLT), due both to being prescribed non-HIS therapy or due to poor adherence. The iASPIRE study provided a cross-sectional analysis of the implementation of secondary prevention strategies across Ireland.Retrospective review of 669 patients recruited during admission for management of acute or chronic CVD, with subsequent follow-up at 6–24 months. Those receiving HIS and non-HIS at follow up were compared. Patients were further stratified by a change in LLT prescription between discharge and follow-up. Baseline characteristics, LDL-C levels, and achievement of secondary prevention targets were analysed.At a mean follow up of 1.21years (SD; 0.71–1.32): 64% (428/669) of patients were prescribed a HIS. Following discharge, 21%(140/669) of patients had their LLT down-titrated. Reasons for change in LLT are listed in table 1. Those prescribed HIS had the lowest LDL-C levels (1.86 mmol/L (IQR 1.55–2.20) vs 2.16 mmol/L(IQR 1.71–2.62;(p < 0.005) and higher rates of guideline-target achievement(table 2). Patients treated for chronic CVD had lower rates of HIS prescription compared to acute CVD(41% vs 65%; P<0.005) and higher LDL-C(2.14mmol(2.06–2.23) vs 1.98 mmol(1.92–2.04). Patients prescribed a non-HIS LLT prior to admission were less likely to be prescribed HIS on discharge (P<0.005). Chronic CVD patients were more likely to be prescribed non-HIS prior to admission (34% vs 18%; p<0.005). Those who attended cardiac rehabilitation (CR) were more likely to be prescribed HIS (67% vs 55%; p=0.014) and had lower LDL-C levels (2.00mmol (1.97–2.03) vs 2.15mmol (2.05–2.27)).A significant proportion of patients are de-escalated from HIS therapy following discharge, subsequently experience smaller declines in LDL-C, and are much less likely to achieve LDL-C targets. There exists therapeutic inertia in escalating LLT.Abstract 88 Table 1List the patient-stand rationale for change in stain therapy since discharge. Figures displayed as count (%). LFT, liver function testsAbstract 88 Table 2Summarises the demographic and clinical characteristics; LDL-C change; and achievement of guideline directed targets for LDL-C in those patients recruited as part of the iASPIRE study, stratified by statin therapy at follow up, and by change in statin therapy since discharge from hospital. Those presenting with ‘Acute’ IHD are those presenting with ACS; those with ‘chronic’ IHD at presentation included those presenting for elective revascularisation. Follow up took place between 6–24 months from index presentation. †due to",
  "authors": [
    {
      "affiliations": [
        "NIPC, Galway, Ireland"
      ],
      "name": "C O’Brien"
    },
    {
      "affiliations": [
        "St James Hospital, Dublin, Ireland"
      ],
      "name": "G Murphy"
    },
    {
      "affiliations": [
        "NIPC, Galway, Ireland"
      ],
      "name": "D Wood"
    },
    {
      "affiliations": [
        "NIPC, Galway, Ireland",
        "Mater Hospital, Dublin, Ireland"
      ],
      "name": "C McCaughey"
    }
  ],
  "title": "88 Changes in statin therapy following discharge in those with cardiovascular disease in Ireland",
  "uid": "888f18df-5327-59ec-9fcb-8d4b2ad349f6"
}