Short- and Long-Term Statin Persistence and Determinants in Patients Initiating Statin Therapy

Abstract

Objective: Despite the established efficacy of statins in reducing major cardiovascular events and mortality, rates of statin persistence remain low. This study aimed to assess short-and long-term statin persistence rates and identify factors influencing persistence in patients initiating statin therapy. Methods: A retrospective, observational, clinical study was conducted, enrolling a consecutive total of 903 patients aged 18 years and older (692 female, 211 male, mean age: 60.74 +/- 11.70 years) who had initiated statin therapy between January 1, 2016, and January 1, 2017. Short-term (2018) and long-term (2023) statin persistence statuses were determined. Groups persisting and non-persisting with statin therapy were compared for demographic characteristics; presence of cardiometabolic diseases such as diabetes mellitus (DM), coronary artery disease (CAD), and hypertension (HT); statin therapy intensities; and indications for statin initiation (primary or secondary prevention) for both time periods. Results: The study included 903 patients with a mean age of 60.7 +/- 11.7 years and a female predominance of 76.6%. In 2018, 498 (55. 1%) patients continued statin therapy, while 405 (44. 9%) discontinued. In 2023, excluding 36 cases with death (18 cases were among those continuing statin treatment, and 18 cases were who did not continue). Four hundred and forty-eight (51. 7%) patients persisted with statin therapy, while 419 (48. 3%) discontinued. Statin non-persistence was more frequent in patients initiated on statins for primary prevention (p<0.01) and more frequent in those under 45 years old (p=0.02 8 and p=0.036, respectively), while it was less common in patients with HT, DM, and CAD (all p<0.01). Conclusions: The study reveals the low and declining rates of statin persistence in patients initiating statin therapy, both in the short and long term. Furthermore, persistence rates are lower in younger patients and those initiated on statins for primary prevention compared to those with established cardiovascular risk factors