- Across 3 cohorts, patients with atherosclerosis, chronic kidney disease (CKD), or diabetes had 40% reduced risk for cardiovascular disease (CVD) event with high-intensity, high-adherence regimens vs 5% with low-intensity regimens combined and nonadherence.
Why this matters
- Low-density lipoprotein cholesterol (LDL) reduction appears to mediate the risk reduction.
- In CVD cohort, adherence at years 1 and 6 with high- vs low-intensity therapy:
- Year 1, high vs low: 84.1% and 57.4%.
- Year 6, high vs low: 72.3% and 48.4%.
- With each 10% increase in combination of high-intensity and good adherence, risk dropped by 10%.
- Vs no treatment, lowest CVD risk seen with high-intensity therapy plus best adherence: HR, 0.60; 95% CI, 0.54-0.68.
- CKD, diabetes cohorts had similar outcomes.
- If all CVD cohort patients adhered optimally to optimal therapy, events would have decreased from 3086 to 2069 (difference: –1017); similar results for other 2 cohorts.
- Retrospective study, 3 UK cohorts, n=29,797 (16,701 CVD; 12,422 type 2 diabetes; 674 CKD) patients receiving first cholesterol-lowering drug prescription, January 1, 2010 through December 31, 2013.
- Intensity: expected LDL reduction
- Outcome: Composite CVD event endpoint.
- Funding: Amgen Europe GmbH.
- Possible confounding underlying adherence behaviors.