High Statin Adherence Improves Outcomes in Atherosclerotic Cardiovascular Disease
Source: The Cardiology Advisor • Date April 17, 2019
In patients with atherosclerotic cardiovascular disease (ASCVD), high adherence to a statin regimen significantly reduces the risk for death, myocardial infarction (MI), and stroke, according to study results presented at the American College of Cardiology 68th Annual Scientific Session held March 16-18, 2019, in New Orleans, Louisiana.
The study included participants age ≥18 who were first diagnosed with ASCVD between 1999 and 2013, had a statin prescription in the first 12 months of diagnosis, and had 5 continuous years of Select Health insurance membership. Types of ASCVD included coronary artery disease (CAD), MI, cardiovascular disease (CVD), and peripheral artery disease (PAD).
The researchers calculated the percentage of days covered (PDC) for statin use by year. They then stratified participants into the following categories: PDC ≥80% for years 1 to 5, PDC ≥80% for years 1 to 3, PDC ≥80% for year 1, and PDC <80% for years 1 to 5. Participants were followed for major adverse clinical events (MACE), including death, MI, and stroke.
Of 5468 participants, 6.4% (n=351) had optimal adherence (PDC ≥80% for years 1 to 5). The results indicated that these participants were more likely to be men, have hypertension and hyperlipidemia, and have been diagnosed with CAD. They were also less likely to smoke and have diabetes or renal failure.
The results indicated that participants with PDC ≥80% for years 1 to 5 had significantly fewer MACE compared with other groups. Compared with PDC <80% years 1 to 5, patients in the PDC ≥80% years 1 to 5 had a hazard ratio of 0.52 for developing MACE.
“Improving adherence is complex, yet these results show the importance of persistence to lipid lowering therapy over the longer term,” wrote the researchers.
May HT, Knowlton KU, Anderson JL, Lappé DL, Bair TL, Muhlestein JB. In patients with atherosclerotic cardiovascular disease, high statin adherence over 5 years of follow-up is associated with improved cardiovascular outcomes: results from the IMPRES study. Presented at: American College of Cardiology 68th Annual Scientific Session. March 16-18, 2019; New Orleans, Louisiana. Abstract 1177-371.