Prescriçäo e aderência das estatinas em pacientes com doença arterial coronariana e hipercolesterolemia / Prescription and adherence to statins of patients with coronary artery disease and hypercholesterolemia

ABSTRACT

OBJECTIVE: Statins have proved to be safe and effective in the secondary prevention of coronary artery disease, but the level of prescription and the reasons for nonadherence to treatment in many coronariopathy treatment centers has not been determined. The purpose of this study was to identify reasons for nonadherence to statin therapy. METHODS: We analyzed 207 consecutive patients with coronary artery disease and hypercholesterolemia (total cholesterol > or = 200mg/dL or LDL - cholesterol > or = 130mg/dL). Patients' average age was 61.7 + or - 10 year; 111 (53.6 percent) male were and 94 (46.6 percent) were female. We analyzed the level of prescription and adherence to treatment with statins. RESULTS: Statins were prescribed for 139 (67 percent) patients, but only 85 (41 percent) used the drug. In spite of being indicated, statins were not prescribed in 68 (33 percent) patients. Of 54 (26 percent) patients, nonadherent to statins, 67 percent did not use the drug due to its high cost, 31 percent due to the lack of instruction, and only 2 percent due to side effects. Total cholesterol (260.3Ý42.2 vs 226.4 + or -51.9; p<0.0001) and LDL cholesterol (174.6 + or -38.1 vs 149.6 + or - 36.1; p<0.0001) were lower in patients on medication. HDL-cholesterol increased from 37.6 + or -9.6 to 41.5 + or -12.9mg/dL (p=0.02), and triglycerides were not modified in patients using statins. CONCLUSION: The prescription of statins in patients with coronary artery disease and dyslipidemia is high; however, its adherence is far from satisfactory, due to the high cost of the medication. Reduction in total cholesterol and LDL cholesterol levels did not reach the targets recommended by the Brazilian Consensus on Dyslipidemia