MedicalResearch.com Interview with:
Robert Rosenson, MD
Professor of Medicine and Cardiology
Icahn School of Medicine at Mount Sinai
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: High intensity statin therapy is underutilized in patients with acute coronary syndromes. In 2011, 27% of patients were discharged on a high intensity statin (Rosenson RS, et al. J Am Coll Cardiol).
In this report, we investigate the factors associated with high adherence to high intensity statin. High adherence to high intensity statins was more common among patients who took high intensity statin prior to their hospitalization, had fewer comorbidities, received a low-income subsidy, attended cardiac rehabilitation and more visits with a cardiologist.
MedicalResearch.com: What should readers take away from your report?
Response: Interventions are needed to improve adherence to high intensity statins in the highest risk patients such as those hospitalized for an acute coronary syndrome. Higher adherence is higher in those enrolled in cardiac rehabilitation and have more frequent visits to the cardiologist.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Lower comorbidity was associated with higher adherence to high intensity statin therapy. Education of the highest risk patients and their providers that high intensity statins lowers the risk of cardiovascular events and procedures remains an ongoing effort.
Interventions to improve treatment adherence such as telephone reminders by the healthcare provider, pharmacy and insurance plans is a critical support mechanism to ensure appropriate treatment of these high risk patients.
It must be emphasized that the use of high intensity statins is the metric and not the achieved LDL cholesterol. A focus on LDL cholesterol may result in down titration of high intensity statin despite the evidence that statins do more than lower risk through lowering LDL cholesterol. Specifically, statins reduce systemic and arterial inflammation and improve plaque stability.
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Lisandro D. Colantonio, Lei Huang, Keri L. Monda, Vera Bittner, Maria-Corina Serban, Benjamin Taylor, Todd M. Brown, Stephen P. Glasser, Paul Muntner, Robert S. Rosenson. Adherence to High-Intensity Statins Following a Myocardial Infarction Hospitalization Among Medicare Beneficiaries. JAMA Cardiology, 2017;
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