IMR Press / RCM / Volume 21 / Issue 4 / DOI: 10.31083/j.rcm.2020.04.189
Open Access Original Research
Patient characteristics, treatment patterns, and adherence to lipid-lowering therapies following an acute coronary syndrome
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1 Endocrinologie, Hospital Pitie-Salpetriere, 75013, Paris, France
2 Health Economics, Amgen SAS, 92100, Boulogne-Billancourt, France
3 Pharmacoepidemiology, Certara, Evidence & Access (previously - Analytica Laser), EC1N 6SN, London, United Kingdom
4 Medical Affairs, Amgen SAS, 92100, Boulogne-Billancourt, France
5 Real World Evidence, Certara, Evidence & Access (previously - Analytica Laser), 75009, Paris, France
6 Health Economics and Outcomes Research, Amgen GmbH, 6343, Rotkreuz, Switzerland
Rev. Cardiovasc. Med. 2020 , 21(4), 643–650;
Submitted: 16 September 2020 | Revised: 9 November 2020 | Accepted: 10 November 2020 | Published: 30 December 2020

Despite dyslipidaemia management guidelines, many patients do not reach low-density lipoprotein cholesterol targets due to insufficiently intensive regimens or lack of adherence to their medication. This was a retrospective cohort study on the Pharmacoepidemiologic General Research eXtension (PGRx)-acute coronary syndrome (ACS) registry. Patients included were 18 years old who suffered an ACS between 2013 and 2016, and treated with lipid-lowering therapy (LLT) at hospital discharge or within 92 days. Patients were followed up to 12 months’ post index ACS, a new cardiovascular event, loss to follow-up or death. Treatment intensity (high, moderate and low intensity statins ± ezetimibe) and adherence (proportion of days covered > 80%) are described. A total of 2,695 patients were included; mean age [SD] was 63.1 [12.8] years, and 77% were men. High, moderate and low intensity statins were started in 56% (1,520), 36% (971), and 3% (86) of patients, respectively. A further 2% (46) were on statin/ezetimibe combination, 2% (42) on other LLT and 1% (30) on ezetimibe alone. At follow-up, around 70% of patients were adherent to LLT, with those on moderate intensity treatments showing better adherence (76%) than those on low (63%) or high (67%) intensity treatments. Despite guideline recommendations, many patients following an ACS are not treated with high intensity statins, and adherence remains far from optimal. Effort should be made to increase the proportion of patients treated with high intensity statins following an ACS and to further improve treatment adherence.

Acute coronary syndrome
treatment intensity
lipid lowering therapy
Fig. 1.
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