Published: July 15, 2014

New research indicates statin drugs must be taken properly

Coronary artery disease patients who are faithful about taking their statin drugs are more likely to reach the goal of reducing their bad cholesterol than those who fail to follow their doctors’ orders, a study by a Michigan State University medical student found.

Margaret Chi was the lead author of the study recently published in the American Journal of Managed Care, a significant accomplishment for a student beginning her fourth year at the College of Human Medicine in Grand Rapids.

“It feels like what I’ve been working on the last few years has come to fruition,” Chi said. “Patients and their physicians will see how important it is to be adherent,” specifically to taking their statins as prescribed.

The study points out the importance of counseling patients who are not adherent, Chi said. For those patients who do take their medications as directed, but still fail to reach the goal of lowering their bad cholesterol, physicians might need to adjust their dosage, she added.

The findings are significant, because coronary artery disease is the most common type of heart disease and the leading cause of heart attacks. Doctors prescribe statins to reduce low-density lipoprotein (LDL), or bad cholesterol, which contributes to the buildup of plaque and the narrowing of the coronary arteries, reducing blood flow to the heart. The typical goal is to lower LDL to less than 100 milligrams per deciliter of blood.

Chi, who has a master’s degree in public health, began the study in 2010 as a research associate at Kaiser Permanente Southern California, a healthcare system. The study included some 67,100 coronary artery disease patients.

Her interest was prompted by earlier studies of how adherent heart failure and HIV patients were in taking their prescriptions. Of the patients in her study, 86 percent took their medication as advised by their physician and had reached their goals for lowering LDL, she said. Of the remaining 14 percent, some were adherent, but had failed to reach their LDL goal, and some were not taking their statins as prescribed.

Men, Asians and Hispanics were most likely to achieve their LDL goals, as were patients on multiple drugs, such as for lowering blood pressure, Chi said. Black patients were less likely to achieve their LDL goal.

“Those not at goal, those are the patients physicians need to target to make sure they are adherent,” she said.

Chi applied to the College of Human Medicine after taking an emergency medical technician class and realizing she enjoyed patient care as much as research. She already is helping with another study, this one of interventional cardiology led by a Grand Rapids cardiologist.

After graduating from the College of Human Medicine next spring, she plans to begin an internal medicine residency, although she added, “Who knows? Maybe I’ll specialize in cardiology afterwards.”

Either way, “Hopefully, I can incorporate research and clinical practice,” she said.

Margaret Chi is a fourth-year medical student in MSU's College of Human Medicine.