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Statin treatment after acute coronary syndrome: Adherence and reasons for non-adherence in a randomized controlled intervention trial
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.ORCID iD: 0000-0001-9571-5946
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2019 (English)In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 9, article id 12079Article in journal (Refereed) Published
Abstract [en]

Studies of secondary prevention for cardiovascular disease show low fulfilment of guidelinere-commended targets. This study explored whether nurse-led follow-up could increase adherence to statins over time and reasons for discontinuation. All patients admitted for acute coronary syndrome at Ostersund hospital between 2010-2014 were screened for the randomized controlled NAILED-ACS trial. The trial comprises two groups, one with nurse-led annual follow-up and medical titration by telephone to reach set intervention targets and one with usual care. All discontinuations of statins were recorded prospectively for at least 36 months and categorized as avoidable or unavoidable. Kaplan-Meier estimates were conducted for first and permanent discontinuations. Predictors for discontinuation were analysed using multivariate Cox regression, statin type and mean LDL-C at end of follow-up. Female gender was a predictor for discontinuation. Allocation in the intervention group predicted increased risk for a first but decreased risk for permanent discontinuation. A nurse-led telemedical secondary prevention programme in a relatively unselected ACS cohort leads to increased adherence to statins over time, greater percentage on potent treatment and lower LDL-C compared to usual care. An initially increased tendency toward early discontinuation in the intervention group stresses the importance of a longer duration of structured follow-up.

Place, publisher, year, edition, pages
2019. Vol. 9, article id 12079
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Cardiac and Cardiovascular Systems
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URN: urn:nbn:se:umu:diva-163065DOI: 10.1038/s41598-019-48540-3ISI: 000481590200120PubMedID: 31427637OAI: oai:DiVA.org:umu-163065DiVA, id: diva2:1361840
Available from: 2019-10-17 Created: 2019-10-17 Last updated: 2019-10-17Bibliographically approved

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Huber, DanielHenriksson, RobinMooe, Thomas
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