Evaluation of the impact of the recent controversy over statins in France: the EVANS study

Abstract

Background: The effect of statins on the prevention of cardiovascular events is well-established. However, a recent controversy in France questioned the value of statins, especially in primary prevention.

Aims: To evaluate the impact of this controversy on patient adherence to statin therapy and its potential clinical impact.

Methods: All patients on statins were recruited consecutively from consultations over a period of 1 month (from March 2013) by five physicians in three centres. Patient demographics and co-morbidities were collected and adherence to statin therapy was evaluated with a questionnaire. We estimated the number of deaths and major cardiovascular events that could be induced per year.

Results: A total of 142 patients were included: 37 in primary prevention (mean age, 68.0±13.1 years; 41% women); 105 in secondary prevention (mean age, 67.6±12.1 years; 20% women). In primary prevention, 24.3% of patients intended to stop statins versus 8.6% in secondary prevention (P<0.001). In France, if the percentages of medication discontinuations following the controversy were actually similar to those we found in our survey, 4992 major cardiovascular events, including 1159 deaths, would be induced in 1 year.

Conclusion: Recent controversy over statins could induce a large proportion of patients to stop their medication and generate a large number of major cardiovascular events.

Keywords: Adherence; Adhérence; BMI; Body Mass Index; CABG; Coronary Artery Bypass Graft; Cost-effectiveness; Coût efficacité; LDL; Low-Density Lipoprotein; MI; Myocardial Infarction; PCI; Percutaneous Coronary Intervention; Prevention; Prévention; Statines; Statins.