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Simulated Application of US Cardiology Guidelines for Statin Use to Hospital Patients in Turkey

Rohrer, James E. PhD; Doganer, Yusuf Cetin MD; Agerter, David C. MD; Aydogan, Umit MD; Barcin, Cem MD

doi: 10.1097/QMH.0000000000000037
Original Articles

Objectives: Simulate the application of the new cardiology prevention guideline on statin use in an angiography clinic sample taken from a hospital in Turkey.

Methods: Taking statins was used as a quality indicator. All cases (323) included in the sample met criteria for taking statins upon arrival in the angiography clinic. The study population was divided into 3 groups: critical coronary artery disease (CAD) (>50%), noncritical (<50%), or individuals with normal coronary arteries. Patient risk factors were tested for association with taking statins using multiple logistic regression analysis.

Results: Only 20.2% of patients were taking statins when they were accepted for coronary angiography. Patients with critical CAD and noncritical CAD had higher odds of receiving statins than persons with no CAD [odds ratio (OR) = 12.9, P < .001 and OR = 3.5, P = .025, respectively]. Patients receiving angiographic interventions for stent control were more likely to be on statins than patients with angina (OR = 5.298, P = 0.004). Compared to those not taking the treadmill test, both those with positive and those with negative results had reduced odds of receiving statins (OR = 0.260, P = .002, and OR = 0.130, P = .002, respectively). Both former and current smokers had lower odds of receiving statins than persons who had never smoked (OR = 0.148, P < .001, and OR = 0.161, P = .001). Patients taking aspirin were at risk of not being on statins (OR = 0.238, P = .001).

Conclusions: Most of the patients in this study were not taking statins comparing according to US guidelines. Patients who exhibited risk factors for a cardiovascular event but who had not been diagnosed with CAD were at risk for not being on statins.

Department of Family Medicine, Mayo Clinic, Rochester, Minnesota (Drs Rohrer and Agerter); Department of Family Medicine, Turkish Military Academy Primary Care Examination Center, Ankara, Turkey (Dr Doganer); and Gulhane Military Medical Faculty, General Dr Tevfik Saglam Caddesi, Etlik, Ankara, Turkey (Drs Aydogan and Barcin).

Correspondence: James E. Rohrer, PhD, Department of Family Medicine, Mayo Clinic, 200 First St SW, Rochester MN 55905 (

No funding was received for this paper. The authors have no conflicts of interest.

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