Adherence to High-Intensity Statins is Low Following Heart Attack

High adherence to statin therapy decreases 2 years after patients are hospitalized for a myocardial infarction, according to the results of a new study.

The retrospective cohort study included 29,932 Medicare beneficiaries aged 66 to 75 years, and 27,956 Medicare beneficiaries over 75 years of age who were hospitalized for myocardial infarction between 2007 and 2012 and filled a high-intensity statin prescription within 30 days after being discharged.
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Statin adherence at 6 months and 2 years was assessed as the primary outcome, and factors that might influence adherence, such as sociodemographic, dual Medicare/Medicaid coverage, comorbidities, patients new to statin therapy, and cardiac rehabilitation and outpatient cardiologist visits post-discharge were analyzed.

At 6 months, 17,633 (58.9%) of the beneficiaries 66 to 75 years of age were taking high-intensity statins with high adherence, 2605 (8.7%) of the beneficiaries had their statin dosage lowered, 5182 (17.3%) had low adherence, and 3705 (12.4%) had discontinued statin therapy.

At 2 years, the number of beneficiaries 66 to 75 years of age taking high-intensity statins with high adherence dropped to 10,308 (41.6%) and low adherence to high-intensity statin therapy increased to 4727 beneficiaries (19.1%). In addition, 3315 (13.4%) had their statin dosage lowered, and 4648 (18.8%) had discontinued statin therapy.

Researchers found similar results for beneficiaries older than 75 years of age, with 39.1% taking high-intensity statin therapy with high adherence at 2 years.

The proportion of those taking high-intensity statins with high adherence increased between 2007 and 2012. Patients new to statin therapy, African American patients, and Hispanic patients were less likely to take high-intensity statin therapy with high adherence.

Beneficiaries were more likely to take high-intensity statin therapy with high adherence if they had dual Medicare/Medicaid coverage, if they made more visits to a cardiologist after discharge, and if they participated in cardiac rehabilitation.

“A substantial proportion of patients filling high-intensity statin prescriptions following a myocardial infarction do not continue taking this medication with high adherence and may benefit from interventions aimed to improve high-intensity statin use,” the researchers concluded.

—Melissa Weiss

Reference:

Colantonio LD, Huang L, Monda KL, et al. Adherence to high-intensity statins following a myocardial infarction hospitalization among Medicare beneficiaries [published April 19, 2017]. JAMA Cardiol. doi:10.1001/jamacardio.2017.0911.