Statin-Specific Adverse Effects Are Best Predictor of Unfavorable LDL Control
Statin-specific side effects are the strongest predictor of a failure to meet low-density lipoprotein cholesterol (LDL-C) targets, with lack of adherence and use of moderate- to low-intensity statins also predicting unfavorable LDL control, according to the results of a recent study.
In order to identify medical and psychosocial factors that contribute to unfavorable LDL-C control, researchers conducted a cross-sectional explorative study involving 1095 participants who were hospitalized with myocardial infarction and/or underwent a coronary revascularization procedure. Sociodemographic, medical, and psychosocial information was collected using medical records, self-report questionnaires, clinical examinations, and blood samples.
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Overall, 57% of participants did not reach LDL-C target of 1.8 mmol/l after 2 to 36 months of follow-up. Experiencing statin-specific adverse side effects (OR 3.23), low statin adherence (OR 3.07), coronary artery bypass graft operation as index treatment (OR 1.95), having one or more coronary event prior to the index event (OR 1.81), female gender (OR 1.80), consuming fish less than 3 times a week (OR 1.56), and use of moderate- or low-intensity statins (OR 1.62) were significantly associated with failure to reach the LDL-C target. Low socioeconomic status and psychosocial factors were not associated with failure to reach LDL-C targets. In continuous analyses, only side effects, low adherence, and use of moderate- or low-intensity statins were associated with LDL-C levels.
“Interventions to improve LDL-C should ensure adherence and prescription of sufficiently potent statins, and address side-effects appropriately,” the researchers concluded.
Munkhaugen J, Sverre E, Otterstad JE, et al. Medical and psychosocial factors and unfavourable low-density lipoprotein cholesterol control in coronary patients [published online February 14, 2017]. Eur J Prev Cardiol. http://journals.sagepub.com/doi/full/10.1177/2047487317693134.