{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T07:03:45Z","timestamp":1789715025159,"version":"4.0.1"},"reference-count":42,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,5,19]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Patients with premature coronary artery disease (CAD) have high rates of recurrent events and death. Information on long\u2010term adherence to lipid\u2010lowering therapy (LLT) and trends in medication\u2010taking behavior in premature CAD is limited. We assessed temporal trends in LLT, factors associated with adherence to LLT, and the consequences of low adherence in a longitudinal cohort of patients with premature CAD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Using a cardiovascular registry and administrative databases, we analyzed temporal changes in rates and predictors of adherence to LLT as well as the association between adherence and cardiovascular outcomes in patients with premature obstructive CAD from 2000 to 2017.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Among 11\u2009411 patients with premature CAD, 27.6% were women and the mean\u00b1SD age was 46.1\u00b15.05\u2009years. The proportion with good first\u2010year adherence to LLT increased from 54.9% to 71.4% (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001) over the study period; however, changes in third\u2010year adherence were much smaller (44.4% versus 47.3%;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). Use of high\u2010intensity LLT increased over the same time period from 26.7% to 92.0% (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). More severe presentation, revascularization at presentation, absence of chronic kidney disease, and nonsmoking were consistently associated with better adherence across the study time frame. Rural residence, female sex, and substance use disorder were associated with poor adherence only in later years. Good adherence was associated with a lower risk of cardiovascular outcomes, including death (hazard ratio [HR], 0.45 [95% CI, 0.39\u20130.55]) and myocardial infarction (HR, 0.53 [95% CI, 0.45\u20130.63]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Use of high\u2010intensity LLT and short\u2010term adherence are improving in patients with premature CAD, but different strategies are needed to increase long\u2010term adherence to prevent recurrent cardiovascular events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.046415","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T09:13:26Z","timestamp":1778058806000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Temporal Trends in Lipid\u2010Lowering Therapy Use and Adherence in Patients With Premature Coronary Artery Disease"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9727-2971","authenticated-orcid":false,"given":"Diana N.","family":"Vikulova","sequence":"first","affiliation":[{"name":"University of British Columbia","place":["Vancouver, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3232-0039","authenticated-orcid":false,"given":"Danielle","family":"Pinheiro\u2010Muller","sequence":"additional","affiliation":[{"name":"University of British Columbia","place":["Vancouver, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0319-7410","authenticated-orcid":false,"given":"Simon N.","family":"Pimstone","sequence":"additional","affiliation":[{"name":"University of British Columbia","place":["Vancouver, Canada"]},{"name":"University of British Columbia","place":["Vancouver, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3686-3807","authenticated-orcid":false,"given":"Liam R.","family":"Brunham","sequence":"additional","affiliation":[{"name":"University of British Columbia","place":["Vancouver, Canada"]},{"name":"University of British Columbia","place":["Vancouver, Canada"]},{"name":"University of British Columbia","place":["Vancouver, Canada"]},{"name":"University of British Columbia","place":["Vancouver, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.04.052"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-023-02925-4"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(02)02862-0"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.037137"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ihj.2022.08.003"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.2307"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2012.3962"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.19.2486"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0828-282X(09)70715-9"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1053\/euhj.1998.1243"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehw106"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000625"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2016.07.510"},{"key":"e_1_3_1_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2015.05.030"},{"key":"e_1_3_1_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.06.005"},{"key":"e_1_3_1_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.505636"},{"key":"e_1_3_1_18_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12872-019-1032-4"},{"key":"e_1_3_1_19_2","doi-asserted-by":"publisher","DOI":"10.2147\/PPA.S245365"},{"key":"e_1_3_1_20_2","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1P150"},{"key":"e_1_3_1_21_2","unstructured":"General guidelines to improve patient adherence to antihypertensive therapy. 2025. 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