High adherence to lipid-lowering drugs reduced all-cause death by 14% (HR 0.86, 95% CI 0.79-0.94) in adults with ischemic stroke or TIA.
Observational (n=9,911)
Yes
Does high adherence to secondary prevention medications reduce all-cause death, recurrent stroke, and MACE in patients with ischemic cerebrovascular disease?
High adherence to secondary prevention medications, particularly lipid-lowering drugs, is associated with a significantly reduced risk of all-cause mortality in patients following an ischemic stroke or TIA.
Effect estimate: HR 0.86 (95% CI 0.79-0.94)
p-value: p=<0.001
Introduction Ischemic cerebrovascular disease (ICD) poses a major global burden. Non-adherence to medical secondary prevention leads to recurrent events and disability. Real-world data on adherence to preventive medications is scarce. The objective here is to determine adherence to secondary prevention of ICD and its effect on clinical outcomes. Methods This retrospective observational study was based on claims data from a large Swiss health insurance. We studied patients aged 18 years or older, who were hospitalized for ICD between 2017 and 2021. Patients’ one-year medication adherence was determined by the medication possession ratio (MPR, high adherence defined as MRP ≥ 0.80). Outcome variables were all-cause death, recurrent stroke, admission to nursing home, and major adverse cardiovascular events. Results A total of 9,911 patients with ischemic stroke or TIA were included in the analysis. Lipid-lowering drugs (LLD) had the largest proportion of high adherence users (63.2%), followed by antihypertensives (55.4%) and antiplatelets (50.0%). Female patients were 37% less likely to adhere to LLD therapy than men, highlighting a significant gender gap. Users with high adherence to LLD had a significantly reduced risk for all-cause death (HR 0.86, 95% CI 0.79, 0.94); Direct oral anticoagulants (HR 0.88, 95% CI 0.78, 1.00) and antihypertensives (HR 0.93, 95% CI 0.85, 1.01) showed a trend towards a protective effect. Discussion A remarkable proportion of patients were non-users or had low adherence to medical secondary prevention. Since insufficient secondary prevention may lead to an increased all-cause death rate, efforts are needed to raise awareness among healthcare professionals and improve patient compliance.
Stollberg et al. (Fri,) conducted a observational in Adults aged 18 years or older with ischemic stroke or transient ischemic attack hospitalized between 2017 and 2021 in Switzerland (n=9,911). High medication adherence to lipid-lowering drugs (LLD) vs. Low medication adherence or non-use of LLD (MPR < 0.80) was evaluated on All-cause death (HR 0.86, 95% CI 0.79-0.94, p=<0.001). High adherence to lipid-lowering drugs reduced all-cause death by 14% (HR 0.86, 95% CI 0.79-0.94) in adults with ischemic stroke or TIA.