Assessment of factors related to statin non-adherence in patients with established coronary artery disease: A single-center observational study

OBJECTIVE
Lifelong statin treatment is recommended in patients with cardiovascular diseases, but drug adherence is a significant problem. The aim of this study was to investigate factors related to statin discontinuation in high-risk patients with coronary artery disease (CAD) diagnosed by coronary angiography.

METHODS
A total of 300 consecutive patients who were followed-up with a diagnosis of CAD were recruited. Patients were categorized as statin adherent or statin non-adherent (patients interrupting statin therapy >30 days). Study participants completed a questionnaire regarding demographic characteristics, medical history, knowledge of statin treatment, and factors related to statin discontinuation.

RESULTS
In all, 160 patients (53.3%) were found to be statin adherent. Of those, 122 patients had suffered myocardial infarction, and atorvastatin was the most prescribed statin on discharge. Among the study population, 26% were illiterate and 55% had graduated from primary school. Only 39 cases (13%) cases had a low-density lipoprotein-cholesterol level <70 mg/dL. In 60% of the statin non-adherent patients, the reason for statin discontinuation was physician discontinuation of the statin prescription. In 14%, the patient stopped the therapy after cholesterol parameters had been reduced or reached the normal range. Only 8% of participants reported that negative information received from TV programs and social media was responsible for the decision to terminate drug use.

CONCLUSION
Our findings demonstrated that the importance of intensive statin treatment in CAD patients has not been recognized by patients or many physicians. Adherence to statin treatment and success of the therapy is low, leading to unnecessarily high cholesterol levels in patients with CAD.