Statin non-adherence and residual cardiovascular risk: There is need for substantial improvement

Banach, Maciej; Stulc, Tomas; Dent, Ricardo; Toth, Peter P.

doi:10.1016/j.ijcard.2016.09.075

Cited by 197Lipoproteins and Cardiovascular HealthMedication Adherence and ComplianceAntiplatelet Therapy and Cardiovascular Diseases

Statin non-adherence and residual cardiovascular risk: There is need for substantial improvement

Banach, Maciej, Stulc, Tomas, Dent, Ricardo, Toth, Peter P.·2016·International Journal of Cardiology

DOI 10.1016/j.ijcard.2016.09.075

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Abstract

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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“the use of high-intensity statins increases side effects”
From Nutraceuticals in the Management of Dyslipidemia: Which, When, and for Whom? Could Nutraceuticals Help Low-Risk Individuals with Non-optimal Lipid Levels? (2021) · cites this paper as [103]
Statins are the drugs of choice in patients with high LDL-C levels and moderate to high CV risk.
“statins are the drugs of choice in patients with high LDL-C levels and moderate to high CV risk”
From Nutraceuticals in the Management of Dyslipidemia: Which, When, and for Whom? Could Nutraceuticals Help Low-Risk Individuals with Non-optimal Lipid Levels? (2021) · cites this paper as [103]
Side effects of statins are associated with reduced therapy adherence and compliance.
“these are associated with reduced therapy adherence and compliance”
From Nutraceuticals in the Management of Dyslipidemia: Which, When, and for Whom? Could Nutraceuticals Help Low-Risk Individuals with Non-optimal Lipid Levels? (2021) · cites this paper as [103]
For most patients with statin-associated muscle symptoms, even up to 95%, statins can still be used with a step-by-step approach, because complete statin intolerance affects only 3% to 5% of patients.
“Moreover, for most (even 95%) of the patients with SAMS, it is still possible to use statins using a step-bystep approach, as complete statin intolerance affects only 3% to 5% patients (10)(11)(12).”
From The Role of Nutraceuticals in Statin Intolerant Patients (2018) · cites this paper as [11]
Statin intolerance limits effective treatment of patients at risk of atherosclerotic cardiovascular disease and is the main cause of statin nonadherence and discontinuation.
“In clinical practice, statin intolerance limits the effective treatment of patients at risk of atherosclerotic cardiovascular disease (CVD), and represents the main cause of statin nonadherence and discontinuation (11,12).”
From The Role of Nutraceuticals in Statin Intolerant Patients (2018) · cites this paper as [11]

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Authors: Banach, M., Stulc, T., Dent, R., & Toth, P. P.
Affiliations: Medical University of Lodz (PL)
Amgen (Switzerland) (CH)
Johns Hopkins University (US)
Corresponding author: Banach, Maciej
ORCID: Banach, Maciej
Toth, Peter P.
Venue: International Journal of Cardiology
Publisher: Elsevier BV
Published: 2016-12
Volume: 225
Pages: 184-196
ISSN: 0167-5273 (ISSN-L)
DOI: 10.1016/j.ijcard.2016.09.075
OpenAlex: W2527622017
Semantic Scholar: aa42dafd862831917c5d07be9d7b34315e7fcc66
Cited by: 197
References: 168
Citations by year: 2026: 10 · 2025: 14 · 2024: 16 · 2023: 16 · 2022: 19 · 2021: 32 · 2020: 29 · 2019: 24 · 2018: 16 · 2017: 20 · 2016: 1
FWCI: 4.03
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: International Journal of Cardiology (publishedVersion)
PubMed (publishedVersion)
Funders: Amgen (Europe) GmbH
Topics: Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Antiplatelet Therapy and Cardiovascular Diseases
Keywords: residual cardiovascular risk, statin discontinuation, LDL cholesterol lowering, PCSK9 inhibitors, hypercholesterolemia, cardiovascular disease prevention, lipid-lowering therapy
MeSH terms: Proprotein Convertase 9, PCSK9 Inhibitors, Cardiovascular Diseases, Humans, Hypercholesterolemia, Cholesterol, HDL, Risk Factors, Sleep Wake Disorders, Randomized Controlled Trials as Topic, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Medication Adherence, Myalgia

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Statin non-adherence and residual cardiovascular risk: There is need for substantial improvement

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