Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Statin Adherence & Mortality in Patients with ASCVD

JAMA Cardiol; ePub 2019 Feb 13; Rodriguez, et al

Low adherence to statin therapy was associated with greater mortality among patients with atherosclerotic cardiovascular disease (ASCVD), a new study found. The retrospective cohort analysis included patients aged 21-85 years who had ≥1 International Classification of Diseases, Ninth Revision, Clinical Modification codes for ASCVD on ≥2 dates in the previous 2 years without intensity changes to their statin prescription. The primary outcomes were death of all causes adjusted for demographic and clinical characteristics, as well as adherence to other cardiac medications. Researchers found:

  • Of 347,104 eligible adults with ASCVD who had stable statin prescriptions, 5,472 (1.6%) were women, 284,150 (81.9%) were white, 36,208 (10.4%) were African American, 16,323 (4.7%) were Hispanic, 4,093 (1.2%) were Pacific Islander, 1,293 (0.4%) were Native American, 1,145 (0.3%) were Asian, and 1,794 (0.5%) were other races.
  • Low adherence was associated with a greater risk of dying.
  • Women, minorities, younger adults, and older adults were less likely to adhere to statins.


Rodriguez F, Maron DJ, Knowles JW, Virani SS, Lin S, Heidenreich PA. Association of statin adherence with mortality in patients with atherosclerotic cardiovascular disease. [Published online ahead of print February 13, 2019]. JAMA Cardiol. doi:10.1001/jamacardio.2018.4936.