From 2001 To 2011, The Trend And Influencing Factors Of The Use Of Statins In Patients With Acute Myocardial Infarction In Hospitals In Rural Areas Of China During Their Hospitalization

Objective:To determine current usage rates and temporal trends in statin therapy,and to analyze factors associated with the lack of any statin therapy among patients hospitalized with acute myocardial infarction in rural China hospitals from the year 2001 to 2011.Methods:A representative sample of patients in rural China admitted to hospital for acute myocardial infarction was created from a two-stage random sampling.In the first phase,a simple random-sampling procedure was used to identify participating hospitals.In the second phase,patients admitted to each participating hospitals for acute myocardial infarction in 2001,2006,and 2011 were selected using a systematic sampling approach.Then clinical information was obtained via central medical record ion for each patient.For analysis of in-hospital statin use in rural China,a multilevel logistic regression models with use of generalized estimating equations was performed to explore associated factors of the use of statin therapy.Results:Among 105 sampled rural hospitals,99 hospitals participated in the study.5,664 patients were identified eligible for statin therapy to determine rates of statin use and the intensity of statin therapy.Between 2001 and 2011,rates of statin use among hospitalized patients with acute myocardial infarction in rural China increased from 12.8%in 2001 to 60.4%in 2006,and 84.3%in 2011(P<0.001 for trend).Among treated patients,those receiving intensive statin therapy increased from 15.3%in 2001 to 55.7%in 2006,and 78.8%in 2011(P<0.001 for trend).The variation in statin use in different low density lipoprotein cholesterol(LDL-C)group decreased overtime.And in the multivariable model,several patient factors were associated with any statin therapy.Patients without LDL-C measured during the hospitalization were significantly less likely to receive statin therapy.Patients with hypertension or chest pain or high level of LDL-C were associated with more likely to receive statin therapy.Conclusions:From the year 2001 to 2011 in rural China,the use of statin therapy has dramatically increased.However,gaps still persisted among guideline and clinical practice.Initiatives promoting the use of statin therapy would support further improvements in practice.