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Age-Related Differences in Non-Persistence with Statin Treatment in Patients after a Transient Ischaemic Attack

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Abstract

Background and Objective

Non-persistence with secondary preventive measures, including medications such as statins, adversely affects the prospects of successful outcomes. This study was aimed at evaluating non-persistence with statin therapy in cohorts of young and elderly patients after a transient ischaemic attack (TIA) and identifying patient-associated characteristics that influence the risk for non-persistence.

Methods

The study cohorts included 797 adult patients who were initiated on statin therapy following a TIA diagnosis between 1 January 2010 and 31 December 2010. Patients were followed up for 3 years and those with a treatment gap of at least a 6-month period were considered ‘non-persistent’. In order to identify any age-related differences, all analyses were conducted in the entire study cohort (n = 797) as well as separately in the ‘younger’ (aged <65 years, n = 267) and the ‘older’ (aged ≥65 years, n = 530) patients.

Results

Non-persistence was significantly more common in younger patients compared to older patients (67.8% vs. 49.1%; p < 0.001). Factors that decreased the probability of non-persistence in younger and older patients included diabetes mellitus (hazard ratio [HR] = 0.72 and HR = 0.64, respectively) and hypercholesterolaemia (HR = 0.43 and HR = 0.62, respectively). Female gender (HR = 1.42) was associated with a higher and increasing number of medications taken (HR = 0.93), with lower probability for non-persistence in younger patients but not in the older patients.

Conclusions

Our results indicate that certain patients with TIA require special counselling to improve persistence with statin therapy. These include younger patients, especially females and those not on polypharmacy, and both younger and older patients without diabetes mellitus or hypercholesterolaemia.

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Authors and Affiliations

  1. Institute of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Comenius University, Sasinkova 4, 811 08, Bratislava, Slovakia

    Martin Wawruch & Gejza Wimmer Jr

  2. General Health Insurance Company, Panónska cesta 2, 851 04, Bratislava, Slovakia

    Dusan Zatko & Beata Havelkova

  3. Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University, Sasinkova 4, 811 08, Bratislava, Slovakia

    Jan Luha

  4. Department of Biophysics, Informatics and Biostatistics, Faculty of Public Health, Slovak Medical University, Limbová 12, 833 03, Bratislava, Slovakia

    Sona Wimmerova

  5. Department of Pharmacology, Faculty of Medicine and Dentistry, Palacky University, Hnevotinska 3, 775 15, Olomouc, Czech Republic

    Petra Matalova

  6. 2nd Department of Neurology, Faculty of Medicine, Comenius University, Limbová 5, 833 05, Bratislava, Slovakia

    Peter Kukumberg

  7. 1st Department of Internal Medicine, Faculty of Medicine, Comenius University, Mickiewiczova 13, 813 69, Bratislava, Slovakia

    Jan Murin

  8. Department of Organisation and Management of Pharmacy, Faculty of Pharmacy, Comenius University, Kalinciakova 8, 832 32, Bratislava, Slovakia

    Tomas Tesar

  9. Independent Pharmaceutical Consultant, 8 Birchdale, Gerrards Cross, Buckinghamshire, SL9 7JA, UK

    Rashmi Shah

Authors
  1. Martin Wawruch
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  2. Dusan Zatko
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  4. Jan Luha
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  8. Jan Murin
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  9. Tomas Tesar
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  10. Beata Havelkova
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  11. Rashmi Shah
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Corresponding author

Correspondence to Martin Wawruch.

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Funding

This study was funded by a Grant from the Scientific Grant Agency of the Ministry of Education, Science, Research and Sport of the Slovak Republic VEGA 1/0112/17. The providers of this Grant played no role in the design, methods, data collection, analysis or interpretation of the data, preparation of the paper or in the decision to submit the manuscript.

Conflicts of interest

All authors of this article declare that they have no conflicts of interest.

Ethical approval

Under the applicable legal requirements of our country, the study did not require the approval of an Ethics Committee. The rules of personal data confidentiality were fully respected.

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Wawruch, M., Zatko, D., Wimmer, G. et al. Age-Related Differences in Non-Persistence with Statin Treatment in Patients after a Transient Ischaemic Attack. Clin Drug Investig 37, 1047–1054 (2017). https://doi.org/10.1007/s40261-017-0559-3

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