Study Design and Population
We conducted a retrospective, observational, cohort study using real-world data from Heart Hospital. The study was approved by HMC Medical Research Centre and Institutional Review Board in Qatar. The study comprised four stages: (1) determining the time to a primary composite outcome of CVD-associated death, non-fatal ACS, and non-fatal stroke within 1 month and 12 months of discharge among high-intensity statin naïve patients admitted with ACS, along with determining the time to secondary effectiveness outcomes within 1 month and 12 months of discharge; (2) determining the effect of the two high-intensity statin dosing regimens (atorvastatin 40mg vs. 80mg) in achieving a goal of reducing LDL-C by ≥ 50% from baseline or LDLC < 70mg/dL; (3) assessing the safety outcomes, including the occurrence of myopathy, rhabdomyolysis, and elevation of liver enzymes to three times the upper limit of normal (ULN) and; (4) conducting a retrospective analysis of the demographic and clinical characteristics of the atorvastatin 80mg vs. 40mg users to identify the predictors of prescribing atorvastatin 80mg among the ACS patients in our facility.
All patients admitted to the Heart Hospital with the diagnosis of ACS, which includes ST-elevation myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI), or unstable angina (UA) during 1 January 2017 and 31 December 2018 were screened for inclusion in the study. Patients who met the inclusion criteria and discharged on high intensity atorvastatin dosing (either atorvastatin 40mg or 80mg oral once daily) were identified. All patients who met the inclusion criteria and discharged on atorvastatin 40mg were included in the atorvastatin 40mg group (atorvastatin 40mg users), while those discharged on atorvastatin 80mg were included in the atorvastatin 80mg group (atorvastatin 80mg users).