Utilization of Statins, an HMG-CoA reductase inhibitors, in Ambon District Hospital, Maluku: a retrospective study

Abstract

Non-infectious diseases, including hypercholesterolemia, are now ranked top 10 in
Indonesia. Statins are inhibitors of HMG-CoA reductase, an enzyme for biosynthesis of
cholesterol in the liver. Statins have been proven to reduce the risk of death due to CHD
and mortality from various reasons. The objective of the study is to know the utilization
of statins in peripheral area of Indonesia. This retrospective study on utilization of statins
prescribed for hypercholesterolemia was taken from medical record year of 2014-2015
of a District Hospital – Dr. Haulussy, Ambon, and Maluku. We collected demographic
data, pre- and treated concentrations of total cholesterol (TC), low-density lipoprotein
cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG),
types and dosages of statins or other lipid-lowering medications given. Student t-test
using was performed to check statistical differences for all cholesterol and TG differences
prior to therapy versus during treatment. Eighty three respondents consisted of 26 men
(31.3%) and 57 women (68.7%) with mean age 60 ± 11 years old. The pre-treatment/
post-treatment values (mg/dL) of TC: 245.22 ± 51.40/224.97 ± 98.79 (p=0.004);
LDL-C: 166.07 ± 45.36/146.00 ± 41.07; HDL-C: 54.52 ± 37.95/43.00 ± 0.00; and
TG: 177.36 ± 103.25/121.00 ± 52.87, respectively. Seventy-nine patients (95.2%)
were treated with statins. The dosage given were 10 mg (n=19, 22.9%), 20 mg (n=
63, 75.9%), and 40 mg (n=1, 1.2%). Twenty-eight patients (33.7%) had no posttreatment
data of cholesterol, and 31 out of 55 patients (56%) were responders. All
cholesterol levels were decreased, but responder rate was only 56%. Therefore, dosage
adjustment and prerequisite cholesterol level during and post-treatment measurement
should be made regularly.