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March 4, 2026Netherlands Heart Journal0 citationsOpen Access

Medication adherence to lipid-lowering agents after percutaneous coronary intervention: nationwide real-world data in the Netherlands

MTM J C TimmermansMWM. Patrick WitvlietJEJudith A. van Erkelens

Key Result

Adherence to lipid-lowering medication 1 year post-elective PCI ranged 71–73% and post-acute PCI 74–76%, with lower adherence in women and elderly patients.

Key Points

  • The study aims to evaluate medication adherence to lipid-lowering agents after percutaneous coronary intervention (PCI) in the Netherlands.
  • Analyzed nationwide real-world data on medication adherence rates after PCI.
  • Measured adherence rates at 1-year post-elective and post-acute PCI.
  • Examined differences in adherence based on gender and age.
  • Lipid-lowering medication adherence ranged from 71-73% after elective PCI.
  • Adherence after acute PCI ranged from 74-76%.
  • Adherence rates for ezetimibe and PCSK9 inhibitors increased throughout the year, while statin use decreased.

Study Design

Type

Observational (n=97,176)

Multicenter

Yes

Structured PICO

P
Population
97,176 patients who underwent acute or elective percutaneous coronary intervention (PCI) from January 1, 2018, to December 31, 2020, in the Netherlands, and survived at least 365 days post-PCI.
I
Intervention
Lipid-lowering medication (statins, ezetimibe, PCSK9 inhibitors)
O
Outcome
Medication adherence to lipid-lowering medication, defined as a medication possession rate (MPR) ≥80% during the year following PCI

Adherence to lipid-lowering therapy remains suboptimal at 1 year post-PCI (71-76%), highlighting the need for targeted interventions, particularly in women and elderly patients.

Limitations

  • Dispensation data used cannot confirm actual medication intake
  • No individual patient clinical data or LDL target levels available
  • Unable to determine reasons for non-adherence or medication switching
  • No linkage between claims data and clinical registries possible due to legal issues
  • Data does not capture combination medication use or multiple statin switching
  • Dispensation does not guarantee medication intake
  • Lack of exact medication prescriptions data
  • Database lacks individual patient clinical data, LDL target achievement, or side effects
  • Inability to link claims data with clinical data on a patient level due to legal issues
  • Cannot distinguish reasons for non-adherence or medication switching patterns

Abstract

This study found lipid-lowering medication adherence 1 year post-elective PCI ranged from 71-73% and post-acute PCI from 74-76%. Lower adherence rates were observed in women and elderly patients. Adherence rates of ezetimibe and PCSK9 inhibitors increased throughout the year following PCI, while statin use decreased.

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Cite This Study

Timmermans et al. (2026) conducted an observational in Patients undergoing percutaneous coronary intervention (PCI) in the Netherlands from 2018 to 2020, aged 18 and older (n=97,176). Lipid-lowering medication (statins, ezetimibe, PCSK9 inhibitors) after PCI vs. None (observational adherence study) was evaluated on Adherence to lipid-lowering medication post-PCI defined as medication possession rate ≥80% during specified periods. Adherence to lipid-lowering medication 1 year post-elective PCI ranged 71–73% and post-acute PCI 74–76%, with lower adherence in women and elderly patients.

synapsesocial.com/papers/69a7cd1dd48f933b5eed91f9https://doi.org/10.1007/s12471-026-02028-8
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