Low-Density Lipoprotein Cholesterol Goal Achievement and Self-Reported Medication Adherence: Insights from the JET-LDL Registry. in The American journal of cardiology / Am J Cardiol. 2024 Sep 30;233:55-61. doi: 10.1016/j.amjcard.2024.09.022.
2024
ASL Torino 3
AOU San Luigi di Orbassano
AO Ordine Mauriziano
Tipo pubblicazione
Journal Article
Autori/Collaboratori (25)Vedi tutti...
Musumeci G
Cardiologia, Azienda Ospedaliera Ordine Mauriziano, Torino, Italy.
Currao A
Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Patti G
Università del Piemonte Orientale, Cardiologia, AOU Maggiore della Carità di Novara, Novara, Italy.
et alii...
Abstract
In patients with recent acute coronary syndromes (ACS), current guidelines recommend a low-density lipoprotein cholesterol (LDL-C) level <55 mg/100 ml. Despite the widespread use of different potent lipid-lowering therapies (LLT), this goal is not always achieved, often owing to less medication adherence. In this prespecified subanalysis of the JET-Low Density Lipoprotein (JET-LDL) registry, we sought to evaluate the relation between LDL-C targets achievement and LLT adherence in a cohort of patients hospitalized for ACS. The patients' self-reported medication adherence was assessed using the Morisky Medication Adherence Scale (MMAS) at 3-month follow-up. Depending on the score obtained, the population was divided into 2 groups: high adherence (HA, MMAS ?6) versus low adherence (LA, MMAS <6). The occurrence of the primary end point (LDL-C reduction >50% from baseline or level <55 mg/100 ml at 1 month) was compared in the 2 groups. A total of 963 patients were included in the present analysis; in 277 cases (28.7%), an MMAS score <6 was reported (LA group), whereas in the remaining 686 (71.3%), the score obtained was ?6 (HA group). No difference between the 2 groups was observed regarding LDL-C levels at admission and LLT prescribed at discharge. At 1 month, the primary end point occurred in 62.5% of cases, with a statistically significant difference between the 2 groups (LA 60% vs HA 65%, p = 0.034). At multivariate logistic regression analysis, LA was identified as an independent predictor of not achieving the primary end point (odds ratio 0.48, 0.39 to 0.85, p = 0.006). In conclusion, in a real-world cohort of patients with ACS, less medication adherence to LLT was a common event (28.7%), negatively affecting LDL-C goal achievement.
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PMID : 39357617
DOI : 10.1016/j.amjcard.2024.09.022
Keywords
medication adherence; lipid-lowering therapies; low-density lipoprotein cholesterol; acute coronary syndrome;