Impact of obesity on tolerance and persistence of statins in patients within 3 months following an acute myocardial infarction: A real-world study
Abstract
Background : Recommended treatment after acute coronary syndrome (ACS) involves high-intensity statin therapy to achieve the low-density lipoprotein (LDL-C) target of<1.4mmol/L (European guidelines), but many patients discontinue statins because of real or perceived side-effects. Whether body mass index (BMI) influences statin intolerance remains unclear. Aim : To assess statin tolerance 3months after initiation, and to identify factors determining tolerance and persistence. Methods : STATIC was a single-centre cohort study (November 2021 to April 2023) of patients admitted to cardiac intensive care units for ACS. The study had three stages: T0 (admission) ; W6 (6 weeks after ACS: statin efficiency); and M3 (3months after ACS: statin tolerance and persistence). SAMS score was used to evaluate imputability in patients reporting muscular side-effects. Multivariable analysis identified factors influencing tolerance; statin persistence was assessed using pharmacy dispensing data. Results : Overall, 289 patients were included (77.9% men; mean age 64.2years; 22.7% with BMI≥30kg/m2). At T0, 38.1% had hypertension, 28.5% dyslipidaemia and 15.9% diabetes. At discharge, 269 patients received statins: 97.0% had a high-intensity statin; 43.5% had a statin/ezetimibe combination. At W6, mean LDL-C was 1.58mmol/L, with 45.5% at the LDL-C target. At M3, 6.0% reported side-effects (3.6% muscular, 1.2% liver, 1.2% gastrointestinal). Mean SAMS score was 5.67. No significant differences in muscular or hepatic side-effects were found between patients with BMI≥30 versus<30 kg/m2. Persistence was 98.4% at M3 follow-up. The proportion of patients on a high-intensity statin or a statin/ezetimibe did not change from discharge to M3 (P=0.45 and P=1.00, respectively). Conclusions : Statins are effective, but not always enough to reach LDL-C target. Tolerance and persistence were good, with muscular side-effects as expected, but without any guarantee of statin imputability. BMI did not influence statin tolerance in this study.
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BibTeX
@article{brobst2026impact,
title = {{Impact of obesity on tolerance and persistence of statins in patients within 3 months following an acute myocardial infarction: A real-world study}},
author = {Morgane Brobst and Nicolas Chapet and Daylale Benchalkha and Elise Bourgeois and Fanchon Herman and Nicolas Molinari and Florence Leclercq and Jean Luc Pasquié and Cyril Breuker and Ariane Sultan and François Roubille},
journal = {Archives of cardiovascular diseases},
year = {2026},
month = sep,
doi = {10.1016/j.acvd.2024.10.332},
url = {https://hal.science/hal-04838759v2},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Impact of obesity on tolerance and persistence of statins in patients within 3 months following an acute myocardial infarction: A real-world study
AU - Morgane Brobst
AU - Nicolas Chapet
AU - Daylale Benchalkha
AU - Elise Bourgeois
AU - Fanchon Herman
AU - Nicolas Molinari
AU - Florence Leclercq
AU - Jean Luc Pasquié
AU - Cyril Breuker
AU - Ariane Sultan
AU - François Roubille
PY - 2026
DA - 2026/09/01
JO - Archives of cardiovascular diseases
DO - 10.1016/j.acvd.2024.10.332
UR - https://hal.science/hal-04838759v2
AB - Background : Recommended treatment after acute coronary syndrome (ACS) involves high-intensity statin therapy to achieve the low-density lipoprotein (LDL-C) target of<1.4mmol/L (European guidelines), but many patients discontinue statins because of real or perceived side-effects. Whether body mass index (BMI) influences statin intolerance remains unclear. Aim : To assess statin tolerance 3months after initiation, and to identify factors determining tolerance and persistence. Methods : STATIC was a single-centre cohort study (November 2021 to April 2023) of patients admitted to cardiac intensive care units for ACS. The study had three stages: T0 (admission) ; W6 (6 weeks after ACS: statin efficiency); and M3 (3months after ACS: statin tolerance and persistence). SAMS score was used to evaluate imputability in patients reporting muscular side-effects. Multivariable analysis identified factors influencing tolerance; statin persistence was assessed using pharmacy dispensing data. Results : Overall, 289 patients were included (77.9% men; mean age 64.2years; 22.7% with BMI≥30kg/m2). At T0, 38.1% had hypertension, 28.5% dyslipidaemia and 15.9% diabetes. At discharge, 269 patients received statins: 97.0% had a high-intensity statin; 43.5% had a statin/ezetimibe combination. At W6, mean LDL-C was 1.58mmol/L, with 45.5% at the LDL-C target. At M3, 6.0% reported side-effects (3.6% muscular, 1.2% liver, 1.2% gastrointestinal). Mean SAMS score was 5.67. No significant differences in muscular or hepatic side-effects were found between patients with BMI≥30 versus<30 kg/m2. Persistence was 98.4% at M3 follow-up. The proportion of patients on a high-intensity statin or a statin/ezetimibe did not change from discharge to M3 (P=0.45 and P=1.00, respectively). Conclusions : Statins are effective, but not always enough to reach LDL-C target. Tolerance and persistence were good, with muscular side-effects as expected, but without any guarantee of statin imputability. BMI did not influence statin tolerance in this study.
SN - 1875-2136
SN - 1875-2128
ER -