Correlation of compliance to statin therapy with lipid profile and serum HMGCoA reductase levels in dyslipidemic patients

BACKGROUND: The efficacy of statin therapy may be lost or vary with reduction in compliance and intensity of statin therapy. OBJECTIVE: To study and correlate the quantitative effect of compliance on lipid profile and 3-hydroxyl-3-methylglutaryl coenzyme A reductase (HMGCoA-R) levels in dyslipidemic patients. METHODS: Compliance to different intensity of statin therapy assessed by pill count was correlated with serum levels of total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), triglycerides (TG), apolipoprotein A1 (ApoA1), apolipoprotein B (ApoB) and HMGCoA-R. RESULTS: Out of 200 patients, 160 received moderate intensity statin therapy whereas 40 were on high intensity statin therapy. The overall mean compliance of patients was 56.7%. The compliance of patients on moderate intensity statin therapy was higher (56.8%) than those on high intensity (56.4%) (p = 0.92). There was significant inverse correlation (p < 0.05) between compliance and TC, TG, LDL-C and HMGCoA-R levels and positive correlation (p < 0.05) with HDL-C levels. The mean serum HMGCoA-R levels did not fall below 9–10 ng/mL when compliance to either moderate or high intensity statin therapy was increased above 60%. CONCLUSIONS: It is appropriate to improve the compliance to existing statin therapy than switching over to higher intensity statin therapy. Estimation of HMGCoA-R levels may be explored as a surrogate marker to monitor and assess the compliance of patients to statin therapy.