Many Patients Don't Respond to Statins, Putting Them at Higher Risk for CV Events

By Kelly Young

Edited by Lorenzo Di Francesco, MD, FACP, FHM

About half of patients taking statins don't experience a substantial lowering of LDL cholesterol, putting them at risk for cardiovascular disease (CVD) events, according to an observational study in Heart.

Using U.K. primary care records, researchers studied 165,000 patients who started statins between 1990 and 2016 and were free of CVD at baseline. Just over half failed to achieve at least a 40% reduction in LDL within 2 years. During a median 6 years' follow-up, those with a suboptimal response to statins had a higher rate of CVD events, compared with optimal responders (22.6 vs. 19.7 events per 1000 person-years). Optimal responders were given medium-potency statins more often than suboptimal responders.

Editorialists note several study limitations — for instance, the proportion of suboptimal responders was probably overestimated since many patients were managed under older guidelines. Nonetheless, they write, "Clinicians should use judgment to refine statin therapy beyond general guideline recommendations on a case-by-case basis ... though one should always consider the incremental benefit of more aggressive statin use."