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[Long-Term Statin Adherence in Patients with Stable Angina after Coronary Stenting]
D I Tomilova1, Y A Karpov2, V V Lopukhova3
1National Medical Research Center for Cardiology.
Insights
Adherence to statin therapy after percutaneous coronary intervention (PCI) decreased significantly over five years. Lower adherence was linked to increased cardiovascular complications in patients with stable angina.
Area of Science:
- Cardiology
- Pharmacology
- Public Health
Background:
- Stable angina requires long-term management.
- Percutaneous coronary intervention (PCI) is a common treatment.
- Statin therapy is crucial for managing cardiovascular risk post-PCI.
Purpose of the Study:
- To assess adherence to statin therapy in stable angina patients post-PCI.
- To investigate the relationship between statin adherence and cardiovascular complications over five years.
Main Methods:
- 574 stable angina patients undergoing elective PCI were studied.
- Statin adherence was assessed at 1 and 5 years via interviews and questionnaires.
- Cardiovascular complications (CVCs) including death, myocardial infarction, stroke, and revascularization were recorded.
Main Results:
- Statin adherence dropped from 84.5% at 1 year to 66.2% at 5 years.
- Low statin doses were common; only 8.7% achieved target low-density lipoprotein cholesterol (LDLC) levels.
- A significant association between adherence and CVCs was analyzed.
Conclusions:
- Long-term adherence to statin therapy post-PCI is suboptimal.
- Declining adherence may contribute to cardiovascular events in stable angina patients.
- Strategies to improve long-term statin adherence are needed.
Purpose:
To study adherence to therapy with statins and its relation to development of cardio-vascular complications (CVC) in patients with stable angina after elective percutaneous coronary intervention (PCI) at five-year observation.
Materials And Methods:
This study comprised 574 patients with stable angina (81 % men, mean age 60.3 years) hospitalized for elective PCI. All patients were prescribed therapy in accordance with recommendations on management of stable angina including statins. Adherence to statin therapy after PCI was assessed in 1 year at telephone interview and in 5 years at ambulatory examination and by filling of an adherence questionnaire. The following CVCs were registered during follow-up after hospital discharge: deaths from all causes, cardiovascular deaths, nonfatal myocardial infarctions and strokes, repetitive myocardial revascularizations. Associations of these events with adherence to hypolipidemic therapy were finally analyzed.
Results:
Mean duration of follow-up was 53.5 (from 3.4 to 67.6) months. In 1 year 490 patients (84.5 %) declared that they continued to take statins. In 5 years number of patients who continued taking statins was 380 (66.2 %). Doses of statins were low (mean for simvastatin 17.4, atorvastatin - 15.8, rosuvastatin - 12.1 mg). Only in 8.7 % of patients level of low density lipoprotein cholesterol (LDLC) was.
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