Statins adherence and associated muscle symptoms in elderly coronary heart disease patients

Abstract

Background: The purpose of the study was to assess adherence to statin therapy and the incidence of statin-associated muscle symptoms in elderly patients with coronary heart disease (CHD) in a real-world clinical setting.

Methods: A cross-sectional observational study was conducted in 10 regions of Russia in clinics with the participation of 166 physicians and 959 patients with CHD aged ≥ 65 years (mean age 69 years, 47.5% women). Medical records were reviewed for medical history, blood lipid levels, and statin type and dosage. A questionnaire was applied to evaluate statin-associated muscle symptoms and reasons for refusal or termination of statin intake.

Results: Risk factors for atherosclerosis in patients were as follows: arterial hypertension–93%, obesity–59.6%, type 2 diabetes mellitus–24.6%, smoking–20.4%. Myocardial infarction and stroke were reported in 31.6% and 9.1% of patients, respectively. Statins were prescribed to 77% of patients. The main reasons for poor adherence to statin therapy were fear of adverse events (46%), lack of motivation to continue treatment (29.4%), polypharmacy (27.6%), memory impairment (26.5%) and insufficient treatment effectiveness (18.8%). Only 11.7% of patients discontinued statin intake due to side effects, whereas 13.5% of patients interrupted treatment because of cost. Muscle symptoms of mild to moderate severity occurred in 9.2% of patients; the rate of increase in serum creatine kinase was 0.83%.

Conclusions: Elderly patients with CHD have demonstrated poor adherence to statin therapy in real-world clinical settings. The incidence of statin-associated muscle symptoms was approximately 10%.

Keywords: Statins, adherence, older patients, coronary heart disease, statin-associated muscle symptoms