Statin non-adherence and residual cardiovascular risk: There is need for substantial improvement. (15th December 2016)

• Record Type: Journal Article
• Authors: Banach, Maciej; Stulc, Tomas; Dent, Ricardo; Toth, Peter P.
• Is Part Of: International journal of cardiology. Volume 225(2016)
• Page Start: 184
• Page End: 196
• Publication Date: 2016-12-15
• Subjects: Statin -- Non-adherence -- Discontinuation -- PCSK9 -- HDL-C -- Statin-associated muscle symptoms -- Cardiovascular risk; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2016.09.075
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Although statin therapy has proven to be the cornerstone for prevention and treatment of cardiovascular disease (CVD), there are many patients for whom long-term therapy remains suboptimal. The aims of this article are to review the current complex issues associated with statin use and to explore when novel treatment approaches should be considered. Statin discontinuation as well as adherence to statin therapy remain two of the greatest challenges for lipidologists. Evidence suggests that between 40 and 75% of patients discontinue their statin therapy within one year after initiation. Furthermore, whilst the reasons for persistence with statin therapy are complex, evidence shows that low-adherence to statins negatively impacts clinical outcomes and residual CV risk remains a major concern. Non-adherence or lack of persistence with long-term statin therapy in real-life may be the main cause of inadequate low density lipoprotein cholesterol lowering with statins. There is a large need for the improvement of the use of statins, which have good safety profiles and are inexpensive. On the other hand, in a non-cost-constrained environment, proprotein convertase subtilisin/kexin type 9 inhibitors should arguably be used more often in those patients in whom treatment with statins remains unsatisfactory. Highlights: Residual CV risk remains a major concern and CV morbidity and mortality. Statin non-adherence may be the main cause of inadequate LDL-C reduction. The causes include cultural reasons, adverse effects, cost, and lack of disease awareness. There is a need for more professional societies to improve the use of statins. PCSK9i should be used more often in pts. where statin therapy remains unsatisfactory.