BACKGROUND AND OBJECTIVE: Non-persistence with secondary preventive measures, including medications such as statins, adversely affects the prospects of successful outcomes. This study was aimed at evaluating non-persistence with statin therapy in cohorts of young and elderly patients after a transient ischaemic attack (TIA) and identifying patient-associated characteristics that influence the risk for non-persistence. METHODS: The study cohorts included 797 adult patients who were initiated on statin therapy following a TIA diagnosis between 1 January 2010 and 31 December 2010. Patients were followed up for 3 years and those with a treatment gap of at least a 6-month period were considered 'non-persistent'. In order to identify any age-related differences, all analyses were conducted in the entire study cohort (n = 797) as well as separately in the 'younger' (aged <65 years, n = 267) and the 'older' (aged ≥65 years, n = 530) patients. RESULTS: Non-persistence was significantly more common in younger patients compared to older patients (67.8% vs. 49.1%; p < 0.001). Factors that decreased the probability of non-persistence in younger and older patients included diabetes mellitus (hazard ratio [HR] = 0.72 and HR = 0.64, respectively) and hypercholesterolaemia (HR = 0.43 and HR = 0.62, respectively). Female gender (HR = 1.42) was associated with a higher and increasing number of medications taken (HR = 0.93), with lower probability for non-persistence in younger patients but not in the older patients. CONCLUSIONS: Our results indicate that certain patients with TIA require special counselling to improve persistence with statin therapy. These include younger patients, especially females and those not on polypharmacy, and both younger and older patients without diabetes mellitus or hypercholesterolaemia.

1st Department of Internal Medicine Faculty of Medicine Comenius University Mickiewiczova 13 813 69 Bratislava Slovakia

2nd Department of Neurology Faculty of Medicine Comenius University Limbová 5 833 05 Bratislava Slovakia

Department of Biophysics Informatics and Biostatistics Faculty of Public Health Slovak Medical University Limbová 12 833 03 Bratislava Slovakia

Department of Organisation and Management of Pharmacy Faculty of Pharmacy Comenius University Kalinciakova 8 832 32 Bratislava Slovakia

Department of Pharmacology Faculty of Medicine and Dentistry Palacky University Hnevotinska 3 775 15 Olomouc Czech Republic

General Health Insurance Company Panónska cesta 2 851 04 Bratislava Slovakia

Independent Pharmaceutical Consultant 8 Birchdale Gerrards Cross Buckinghamshire SL9 7JA UK

Institute of Medical Biology Genetics and Clinical Genetics Faculty of Medicine Comenius University Sasinkova 4 811 08 Bratislava Slovakia

Institute of Pharmacology and Clinical Pharmacology Faculty of Medicine Comenius University Sasinkova 4 811 08 Bratislava Slovakia

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