Quality standard

Quality statement 6: Statins for secondary prevention

Quality statement 6: Statins for secondary prevention

Quality statement

Adults with newly diagnosed cardiovascular disease (CVD) are offered atorvastatin 80 mg.

Rationale

High‑intensity statins are the most clinically effective option for the secondary prevention of CVD – that is, reducing the risk of future CVD events in people who have already had a CVD event, such as a heart attack or stroke. Evidence shows that atorvastatin 80 mg is the most cost‑effective high‑intensity statin for the secondary prevention of CVD, which can improve clinical outcomes.

Quality measures

The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.

Structure

Evidence of local arrangements to ensure that adults with newly diagnosed CVD are offered atorvastatin 80 mg.

Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example, from local protocols.

Process

Proportion of adults with newly diagnosed CVD who are prescribed atorvastatin 80 mg.

Numerator – the number in the denominator prescribed atorvastatin 80 mg.

Denominator – the number of adults with newly diagnosed CVD.

Data source: Data on prescription of atorvastatin 80 mg for adults with newly diagnosed CVD can be collected from information recorded locally by healthcare professionals and provider organisations, for example, from patient records. Publicly available national data on use of lipid lowering therapies in general practice patients with CVD is available from CVD Prevent's indicator CVD009CHOL. This reports the percentage of patients aged 18 and over with GP recorded CVD who are currently treated with lipid lowering therapy.

Outcome

Proportion of adults with CVD choosing statin treatment who have a low-density lipoprotein (LDL) cholesterol level of 2.0 mmol per litre or less, or non-high-density lipoprotein (HDL) cholesterol level of 2.6 mmol per litre or less.

Numerator – the number in the denominator who have an LDL cholesterol level of 2.0 mmol per litre or less, or non-HDL cholesterol level of 2.6 mmol per litre or less.

Denominator – the number of adults with CVD choosing statin treatment.

Data source: Data on achievement of NICE recommended lipid targets can be collected from information recorded locally by healthcare professionals and provider organisations, for example, from patient records. Publicly available national data on lipid targets for adults with CVD is available from CVD Prevent's indicator CVD007CHOL and Quality Outcomes Framework (QOF) indicator CHOL002. CVD Prevent's indicator CVD007CHOL reports the percentage of patients aged 18 and over with GP recorded CVD in whom the most recent blood cholesterol level (measured in the preceding 12 months) is non-HDL cholesterol less than 2.5 mmol/L or LDL-cholesterol less than 1.8 mmol/L. QOF indicator CHOL002 measures the percentage of patients with CVD who have a recording of non-HDL cholesterol in the preceding 12 months that is lower than 2.5 mmol/L, or where non-HDL cholesterol is not recorded, a recording of LDL cholesterol in the preceding 12 months that is lower than 1.8 mmol/L.

What the quality statement means for different audiences

Service providers (such as primary care services and secondary care services) ensure that adults with newly diagnosed CVD are offered atorvastatin 80 mg.

Healthcare professionals (such as GPs, doctors in secondary care, nurse prescribers and pharmacists) offer atorvastatin 80 mg to adults with newly diagnosed CVD.

Commissioners ensure that adults with newly diagnosed CVD are offered atorvastatin 80 mg. Commissioners may do this by seeking evidence of practice through clinical audits.

Adults who have been newly diagnosed with CVD are offered a statin called atorvastatin to help reduce their chances of further problems, such as a heart attack or stroke.

Definitions of terms used in this quality statement

Cardiovascular disease

Angina, previous myocardial infarction, revascularisation, ischaemic stroke or TIA (excluding a history of haemorrhagic stroke) or symptomatic peripheral arterial disease. [NICE indicator NM212]

Atorvastatin 80 mg

In May 2023, this was an off-label use of atorvastatin. See NICE's information on prescribing medicines.