CONGRESS ABSTRACT

IntroductionThe poor adherence (A) and persistence (P) to statin therapy, represents the main problem of long-term therapy in patients at high and very high cardiovascular (CV) risk, leading to an increased risk of CV events (death, ACS recurrence, ischemic stroke, new hospitalization) and healthcare costs. Patients with acute coronary syndrome (ACS) have an extremely high incidence of new CV events. Patients with associated multivessel coronary disease, peripheral arterial disease, diabetes mellitus, multiple CV events or familial hypercholesterolemia are characterized by prohibitive CV risk and often need a combination lipid-lowering therapy to achieve LDL target. AimTo evaluate A e P to statin therapy in ACS patients discharged from our department with triple lipid-lowering therapy (high intensity statin, ezetimibe, PCSK9 inhibitors), managed in sharing with the hospital pharmacy during follow-up. MethodsWe evaluated A e P of 126 patients from January 2020 to December 2023 thanks to shared database provided by the Territorial Pharmaceutical Service of Turin. A was classified according the medical possession rate (MPR) in high A if MPR ≥ 80% and low A if MPR <40 %. The following variables were collected: age, gender, statin type and dosage and packs dispensed and prescribed by the general practitioner. The A and P at 3 months, 6 months and 12 months follow-up were investigated. Moreover, analysis on patients’ subgroups according to gender and age (> o ≤ di 60 years old), had been carried out. ResultsThe mean age of the overall population was 62,9 years old and 16% were female. At 12 months follow-up, high A prevalence was 80%, intermediate 15% and low 5%. Age-stratified analysis showed adherence rates of 76% high, 10% intermediate, and 14% low for patients ≤60 years old, and 83% high, 8% intermediate, and 9% low for patients >60 years old. The P at 3, 6 and 12 months follow-up were 91%, 75% e 46%, respectively. Kaplan Meier estimator analysis showed that up to 10 months follow-up patients >60 yo presented a greater prevalence of P, after there was not difference (fig 1). A shows no difference according to gender (fig 2). ConclusionIn this selected group of patients (ACS discharged with triple lipid-lowering therapy), adherence and persistence to statin therapy were significantly higher than described in literature, probably because the combination lipid-lowering therapy may increase patient awareness of its utility in preventing cardiovascular events.