TRENDS AND PREDICTORS OF STATIN USE FOLLOWING ACUTE CORONARY SYNDROME: INSIGHTS FROM A CENTRAL MASSACHUSETTS PROSPECTIVE REGISTRY

IF 5.9 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American journal of preventive cardiology Pub Date : 2025-09-01 DOI:10.1016/j.ajpc.2025.101177

Khanh-Van Tran MD PhD , Cassie R. Shao BA , Katherine A. Tak BA , Elisa M. Taylor-Yeremeeva BA , Carrie R. Shao BA , Nouran Y. Nagy MS , Asem Ali MD

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Abstract

Therapeutic Area

CVD Prevention – Primary and Secondary

Background

Statin therapy is a cornerstone of secondary prevention in patients with acute coronary syndrome (ACS). While initiation during hospitalization is high, long-term adherence remains suboptimal. Real-world data on post-discharge statin adherence in community-based populations are limited. We aimed to characterize statin use trends and identify predictors of adherence at 6 and 12 months in a prospective cohort from Central Massachusetts.

Methods

We analyzed 217 patients enrolled in the Transitions, Risks, and Actions in Coronary Events – Center for Outcomes Research and Education (TRACE-CORE) prospective registry. Statin use was assessed during hospitalization and at 6- and 12-months post-discharge. Logistic regression was used to evaluate whether demographic and clinical factors (age, sex, race/ethnicity, BMI) were associated with continued statin use.

Results

The mean age was 63.2 ± 11.8 years, and 61% of participants were male. Statins were initiated during hospitalization in 96.6% of patients. Adherence declined to 87.1% at 6 months and 81.1% at 12 months. Logistic regression models revealed no significant associations between statin adherence and age, sex, race/ethnicity, or BMI at either time point (all p > 0.05). The 6-month model had a Nagelkerke R² of 0.039 (p = 0.338), and the 12-month model had a Nagelkerke R² of 0.030 (p = 0.402), indicating limited explanatory power.

Conclusions

Despite high inpatient initiation, nearly one in five ACS patients discontinued statin therapy by 12 months. Traditional demographic and clinical characteristics did not explain adherence patterns. These findings, derived from a prospective, community-based registry, underscore the limitations of relying solely on demographic or clinical predictors and highlight the need for real-world behavioral and system-level interventions.

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急性冠脉综合征后他汀类药物使用的趋势和预测因素：来自马萨诸塞州中部前瞻性登记的见解

治疗领域acvd预防-一级和二级背景他汀类药物治疗是急性冠脉综合征（ACS）患者二级预防的基石。虽然住院期间的起始率很高，但长期依从性仍然不是最佳的。社区人群出院后他汀类药物依从性的真实数据是有限的。我们的目的是在马萨诸塞州中部的前瞻性队列中描述他汀类药物的使用趋势，并确定6个月和12个月依从性的预测因素。方法：我们分析了冠脉事件的转变、风险和行为——结局研究和教育中心（TRACE-CORE）前瞻性登记的217例患者。在住院期间和出院后6个月和12个月评估他汀类药物的使用情况。采用Logistic回归评估人口学和临床因素（年龄、性别、种族/民族、BMI）是否与他汀类药物的持续使用相关。结果平均年龄63.2±11.8岁，男性占61%。96.6%的患者在住院期间开始使用他汀类药物。6个月时依从性下降到87.1%，12个月时下降到81.1%。Logistic回归模型显示，他汀类药物依从性与年龄、性别、种族/民族或任何时间点的BMI均无显著相关性（均p >； 0.05）。6个月模型的Nagelkerke R²为0.039 (p = 0.338)，12个月模型的Nagelkerke R²为0.030 (p = 0.402)，说明解释力有限。结论：尽管住院率很高，但近五分之一的ACS患者在12个月后停止他汀类药物治疗。传统的人口学和临床特征不能解释依从性模式。这些发现来源于前瞻性的、基于社区的登记，强调了仅仅依赖人口统计学或临床预测因素的局限性，并强调了现实世界行为和系统层面干预的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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