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


OBJECTIVE
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.


CONCLUSIONS
Recent controversy over statins could induce a large proportion of patients to stop their medication and generate a large number of major cardiovascular events.
Division of Coronary Artery Disease and Intensive Cardiac Care, Georges-Pompidou European Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), University Paris-Descartes, 20, rue Leblanc, 75015 Paris, France.
Anis
A
Saib
Laurent
L
Sabbah
Ludivine
L
Perdrix
Didier
D
Blanchard
Nicolas
N
Danchin
Etienne
E
Puymirat
D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D015897:Comorbidity; D050171:Dyslipidemias / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D005260:Female; D005602:France; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D033182:Intention; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D011322:Primary Prevention / Q000379:methods*; D018570:Risk Assessment; D012307:Risk Factors; D055502:Secondary Prevention / Q000379:methods*; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
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