Factors Associated with Reinitiation of Statin Treatment in Older Patients with Peripheral Arterial Disease

: Martin Wawruch, Gejza Wimmer Jr, Jan Murin, Martina Paduchova, Tomas Tesar, Lubica Hlinkova, Peter Slavkovsky, Emma Aarnio

Publisher: ADIS INT LTD

: 2020

Drugs and Aging

DRUGS & AGING

: DRUG AGING

: 37

: 8

: 595

: 604

: 10

: 1170-229X

: 1179-1969

DOI: https://doi.org/10.1007/s40266-020-00772-z

Background Long-term persistence represents a basic precondition of successful statin treatment in patients with peripheral arterial disease (PAD). Objectives The aims of our study were evaluation of reinitiation in older PAD patients who were non-persistent with statin treatment, and identification of patient-related characteristics associated with the patient's probability of reinitiation.
Methods Our study cohort included 2977 older patients (>= 65 years) who were non-persistent with statin treatment in whom PAD was newly diagnosed in 2012. Reinitiation was defined as the first statin prescription recorded after discontinuation. To analyze factors associated with the patient ' s probability of reinitiation, Cox regression with time-dependent covariates was applied.
Results After post-discontinuation follow-up of a mean of 27 months, reinitiation of statin treatment was recorded for 1244 (41.8%) patients. Increasing age, Parkinson's disease, being a new statin user (patient in whom statin treatment was initiated in association with PAD diagnosis), general practitioner as the index prescriber who prescribed a statin for the first time after diagnosis of PAD, coadministration of loop diuretics, and longer persistence before discontinuation decreased the patient's likelihood of reinitiation, whereas myocardial infarction during non-persistence, high-intensity statin treatment, and increasing number of medications increased the patient's probability of reinitiation. Conclusions In patients with characteristics associated with a lower probability of reinitiation, more concentrated outreach and further evaluation of these groups to identify interventions that might be helpful to encourage reinitiation are needed.