Statin non-adherence and residual cardiovascular risk: There is need for substantial improvement
Language English Country Netherlands Media print-electronic
Document type Journal Article, Review
PubMed
27728862
DOI
10.1016/j.ijcard.2016.09.075
PII: S0167-5273(16)32483-4
Knihovny.cz E-resources
- Keywords
- Cardiovascular risk, Discontinuation, HDL-C, Non-adherence, PCSK9, Statin, Statin-associated muscle symptoms,
- MeSH
- Medication Adherence * MeSH
- Cholesterol, HDL antagonists & inhibitors blood MeSH
- Hypercholesterolemia blood drug therapy MeSH
- Cardiovascular Diseases blood drug therapy MeSH
- Humans MeSH
- Myalgia chemically induced MeSH
- PCSK9 Inhibitors MeSH
- Sleep Wake Disorders chemically induced MeSH
- Randomized Controlled Trials as Topic methods MeSH
- Risk Factors MeSH
- Hydroxymethylglutaryl-CoA Reductase Inhibitors adverse effects therapeutic use MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
- Names of Substances
- Cholesterol, HDL MeSH
- PCSK9 Inhibitors MeSH
- PCSK9 protein, human MeSH Browser
- Hydroxymethylglutaryl-CoA Reductase Inhibitors MeSH
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.
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