A new study has found that patients with atherosclerotic
cardiovascular disease cut their risk of a second major adverse cardiovascular
event by almost 50%, if they adhere to taking a statin medication as prescribed
by their doctors. However, researchers from the Intermountain Healthcare Heart
Institute in Salt Lake City found that only about 6% of patients are in fact
following the statin regimen given to them to lower their cholesterol, negating
any potential cardiovascular benefits.
Results of the study were presented yesterday (16 March) at
the American College of Cardiology Scientific Sessions in New Orleans.
“A lot of clinical trials have shown that statins
reduce the risk of secondary outcomes, so it’s really important that they take
these medications,” said the study’s principal investigator, Heidi May, PhD,
principal investigator of the study, and cardiovascular epidemiologist at the
Intermountain Healthcare Heart Institute. “The surprising thing that we
found is that so few patients, even within an insured population, just didn’t
take their statin medication as prescribed.”
In the study, researchers identified 5468 patients first
diagnosed with atherosclerotic cardiovascular disease between 1999 and 2013.
These patients received a statin prescription to reduce their cholesterol
within the first 12 months of diagnosis. Researchers then looked at two things:
whether or not the patients took their medication, and how many major adverse clinical
events (stroke, heart attack, or death) they had over the next five years.
They found that patients with optimal adherence – who took
their statins as prescribed at least 80% of the time – reduced their risk of
dying or having a heart attack or stroke by nearly 50%. Unfortunately, though,
only 351 out of those 5468 patients (6%) fell into the optimal adherence
Researchers also found that 25% of patients never filled
their statin prescription in the first place, and 25% didn’t fill their second
Researchers think there are several reasons for
non-adherence, including a bias against statins, concern that they’re already
taking too many medications, worry about side-effects, the incorrect belief
that after a few years on statins, they’re cured and don’t need to take them
anymore, or they are just not that important.
Dr May believes the importance of taking statins could be
lost in the abundance of information patients are given at discharge.
“During this time, patients most likely don’t feel
their best, they’re probably scared about what just happened to them, and
nervous about their future. They may not be able to process everything that’s
happening and how to best follow up,” she said.
Dr. May added that the findings of the study should help
caregivers see how crucial it is to ensure their patients who are being
discharged understand the importance of the medication, and that continual
education needs to be provided about the importance of taking their medications
“The patients should be asked about whether or not
they’re taking their statin at their follow-up appointments, especially soon
after discharge,” Dr May said.
“This is important research to better understand the
real-world treatment of atherosclerotic cardiovascular disease, and to validate
the benefits of statins as proven first-line therapy and the challenges
associated with poor adherence,” said Dr. May.
College of Cardiology Scientific Sessions