Good adherence to lipid-lowering therapy in patients with premature CAD was associated with a lower risk of death (HR 0.45; 95% CI 0.39-0.55) and myocardial infarction (HR 0.53; 95% CI 0.45-0.63).
Cohort
Does good adherence to lipid-lowering therapy reduce cardiovascular outcomes including death and myocardial infarction in patients with premature coronary artery disease?
Good adherence to lipid-lowering therapy in patients with premature coronary artery disease is associated with a significantly lower risk of death and myocardial infarction.
Effect estimate: HR 0.45 (95% CI 0.39-0.55)
BACKGROUND: Patients with premature coronary artery disease (CAD) have high rates of recurrent events and death. Information on long-term adherence to lipid-lowering therapy (LLT) and trends in medication-taking behavior in premature CAD is limited. We assessed temporal trends in LLT, factors associated with adherence to LLT, and the consequences of low adherence in a longitudinal cohort of patients with premature CAD. METHODS: Using a cardiovascular registry and administrative databases, we analyzed temporal changes in rates and predictors of adherence to LLT as well as the association between adherence and cardiovascular outcomes in patients with premature obstructive CAD from 2000 to 2017. RESULTS: <0.001). More severe presentation, revascularization at presentation, absence of chronic kidney disease, and nonsmoking were consistently associated with better adherence across the study time frame. Rural residence, female sex, and substance use disorder were associated with poor adherence only in later years. Good adherence was associated with a lower risk of cardiovascular outcomes, including death (hazard ratio HR, 0.45 95% CI, 0.39-0.55) and myocardial infarction (HR, 0.53 95% CI, 0.45-0.63). CONCLUSIONS: Use of high-intensity LLT and short-term adherence are improving in patients with premature CAD, but different strategies are needed to increase long-term adherence to prevent recurrent cardiovascular events.
Vikulova et al. (Wed,) conducted a cohort in Premature coronary artery disease. Good adherence to lipid-lowering therapy vs. Poor adherence was evaluated on Death (HR 0.45, 95% CI 0.39-0.55). Good adherence to lipid-lowering therapy in patients with premature CAD was associated with a lower risk of death (HR 0.45; 95% CI 0.39-0.55) and myocardial infarction (HR 0.53; 95% CI 0.45-0.63).