Drug Utilization of Statin Therapy in Patients with Acute Coronary Syndrome at the Cardiology and Cardiovascular Outpatient Clinic of Airlangga University Hospital

Abstract

Acute coronary syndrome (ACS) remains a major cause of cardiovascular morbidity and mortality, and intensive low-density lipoprotein cholesterol (LDL-C) reduction with high-intensity statin therapy is essential for secondary prevention. This study aimed to evaluate statin utilization, treatment appropriateness, drug-related problems, and LDL-C target attainment among patients with ACS. A retrospective observational study was conducted at the Cardiology and Cardiovascular Outpatient Clinic of Universitas Airlangga Hospital, Surabaya, Indonesia. Medical records of patients treated from July to December 2023 were reviewed, and 51 eligible patients receiving statin therapy were included using total sampling. Data were analyzed descriptively. Moderate-intensity statins predominated; simvastatin 20 mg was the most frequently prescribed statin during the first month, whereas atorvastatin 20 mg predominated during the second month, while atorvastatin 40 mg use remained limited. Inappropriate statin therapy was identified in 45 patients (88.24%), including inadequate statin intensity and insufficient treatment duration. Only two patients (3.9%) achieved the recommended LDL-C target of ?55 mg/dL, both after receiving atorvastatin 40 mg. Suspected statin-associated muscle symptoms occurred in four patients (7.84%), while several potential drug–drug interactions were documented. These findings demonstrated that statin therapy for secondary prevention remained suboptimal, highlighting the need for guideline-concordant prescribing, regular LDL-C monitoring, and systematic management of identified drug-related problems.