Adherence to High-Intensity Statin Drops-off For Many Following Heart Attack

New York, NY
 – April 19, 2017 /Press Release/  –– 

A substantial proportion of patients prescribed high-intensity statins following hospitalization for a heart attack did not continue taking this medication with high adherence at two years after discharge, according to a study published by JAMA Cardiology.

High-intensity statins are recommended following myocardial infarction (MI; heart attack). Robert S. Rosenson, M.D., of the Icahn School of Medicine at Mount Sinai, New York, and colleagues conducted a study that included Medicare beneficiaries ages 66 to 75 years (n = 29,932) and older than 75 years (n = 27,956) hospitalized for MI between 2007 and 2012 who filled a high-intensity statin prescription (atorvastatin, 40-80 mg, and rosuvastatin, 20-40 mg) within 30 days of discharge. Beneficiaries had Medicare fee-for-service coverage including pharmacy benefits.

At six months and two years after discharge among those 66 to 75 years of age, 59 percent and 42 percent were taking high-intensity statins with high adherence (a proportion of days covered of at least 80 percent), 8.7 percent and 13 percent down-titrated (switching to a low/moderate-intensity statin with a proportion of days covered of at least 80 percent), 17 percent and 19 percent had low adherence (a proportion of days covered less than 80 percent for any statin intensity without discontinuation), 12 percent and 19 percent discontinued their statin, respectively (not having a statin available to take in the last 60 days of each follow-up period).

The proportion taking high-intensity statins with high adherence increased between 2007 and 2012. African American and Hispanic patients and new high-intensity statin users were less likely to take high-intensity statins with high adherence, and those with dual Medicare/Medicaid coverage and more cardiologist visits after discharge and who participated in cardiac rehabilitation were more likely to take high-intensity statins with high adherence . Results were similar among beneficiaries older than 75 years of age.

“Lower medication costs, cardiologist visits, and cardiac rehabilitation may contribute to improving high¬ intensity statin use and adherence after myocardial infarction,” the authors write.

(JAMA Cardiology. Published online April 19, 2017; doi:10.1001/jamacardio.2017.0911. Available pre-embargo to the media at http://media.jamanetwork.com.)

Editor’s Note: The design and conduct of the study, analysis, and interpretation of the data, and preparation of the manuscript, was supported through a research grant from Amgen Inc. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, etc.

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The Mount Sinai Health System is an integrated health system committed to providing distinguished care, conducting transformative research, and advancing biomedical education. Structured around seven hospital campuses and a single medical school, the Health System has an extensive ambulatory network and a range of inpatient and outpatient services—from community-based facilities to tertiary and quaternary care.

The System includes approximately 7,100 primary and specialty care physicians; 12 joint-venture ambulatory surgery centers; more than 140 ambulatory practices throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and 31 affiliated community health centers. Physicians are affiliated with the renowned Icahn School of Medicine at Mount Sinai, which is ranked among the highest in the nation in National Institutes of Health funding per investigator. The Mount Sinai Hospital is in the “Honor Roll” of best hospitals in America, ranked No. 15 nationally in the 2016-2017 “Best Hospitals” issue of U.S. News & World Report.  The Mount Sinai Hospital is also ranked as one of the nation’s top 20 hospitals in Geriatrics, Gastroenterology/GI Surgery, Cardiology/Heart Surgery, Diabetes/Endocrinology, Nephrology, Neurology/Neurosurgery, and Ear, Nose & Throat, and is in the top 50 in four other specialties. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 10 nationally for Ophthalmology, while Mount Sinai Beth Israel, Mount Sinai St. Luke's, and Mount Sinai West are ranked regionally. Mount Sinai’s Kravis Children’s Hospital is ranked in seven out of ten pediatric specialties by U.S. News & World Report in "Best Children's Hospitals."

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