Statin-specific side effects, poor medication adherence, and suboptimal statin prescribing are the major factors associated with unfavourable low-density lipoprotein cholesterol (LDL-C) control, according to the authors of a new study published in the European Journal of Preventive Cardiology .
The conclusion follows a study of 1,095 patients hospitalised with myocardial infarction and/or requiring coronary revascularisation.
The authors found that 57 per cent of patients did not reach the LDL-C target of 1.8mmol/l at follow-up. Low socioeconomic status and psychosocial factors were not associated with the failure to reach target. Instead, patients with side effects were more than three-times more likely to fall short of target. Those with low statin adherence were three-times more likely to miss the target than patients who adhered. Patients prescribed moderate- or low-intensity statins were 62 per cent more likely to miss the target than those prescribed high-intensity statins.
While the use of high-intensity statins was significantly more frequent in patients who achieved target, the authors cautioned that this relationship needs to be clarified before advice can be given about the potency of statins that should be prescribed.