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Medication adherence to lipid-lowering agents after percutaneous coronary intervention: nationwide real-world data in

Marijke J C Timmermans1, M Patrick Witvliet2, Judith A van Erkelens3

  • 1Netherlands Heart Registration, Utrecht, The Netherlands. marijke.timmermans@nhr.nl.

Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation
|March 2, 2026
PubMed

Insights

Lipid-lowering medication adherence after percutaneous coronary intervention (PCI) was around 71-76% in the first year. Adherence was lower in women and elderly patients, with statin use declining while ezetimibe and PCSK9 inhibitors increased.

Area of Science:

  • Cardiology
  • Pharmacology
  • Public Health

Background:

  • Lipid-lowering medications are crucial for reducing cardiovascular events and mortality.
  • Patient adherence to lipid-lowering therapy remains a significant challenge.
  • Understanding adherence patterns post-percutaneous coronary intervention (PCI) is vital for optimizing cardiovascular care.

Purpose of the Study:

  • To evaluate lipid-lowering medication adherence rates in the first year after acute and elective PCI.
  • To analyze adherence trends for different classes and subtypes of lipid-lowering drugs.
  • To identify patient demographics associated with lower adherence.

Main Methods:

  • Retrospective cohort study using a nationwide Dutch claims database (Vektis).
  • Inclusion of 97,176 patients undergoing PCI between 2018-2020.
  • Adherence defined as a medication possession rate of 80% or higher.

Main Results:

  • First-year adherence post-elective PCI was 71-73%; post-acute PCI was 74-76%.
  • Adherence for ezetimibe and PCSK9 inhibitors increased, while statin adherence decreased over the year.
  • Lower adherence was noted in females and patients aged 80 years and older.

Conclusions:

  • Lipid-lowering medication adherence one year post-PCI is suboptimal, particularly in specific demographic groups.
  • Trends indicate a shift from statins towards ezetimibe and PCSK9 inhibitors during the first year.
  • Targeted interventions may be needed to improve adherence in vulnerable patient populations.
Abstract

Keywords:
Claims dataLipid-lowering medicationMedication adherencePercutaneous Coronary Intervention

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