Of 254,035 new statin users at Mass General Brigham, 10,644 (4.2%) developed clinician-documented intolerance after a median 3.1 years. Within 90 days, 39.9% stopped all lipid-lowering therapy and fewer than 10% received a nonstatin-based strategy. At 3 to 6 months, mean LDL cholesterol rose 6.8 mg/dL in discontinuers and fell 4.9 mg/dL in continuers. Against statin-tolerant patients, intolerance had hazard ratios of 1.12 to 1.55 for revascularisation, myocardial infarction and ischaemic stroke. Among intolerant patients, stopping all therapy had hazard ratios from 1.38 for death to 2.14 for venous thromboembolism. The time-varying Cox analysis is observational and from one health system, so those who stopped may differ in other ways.
Why it is interesting: Two in five patients recorded as statin-intolerant stopped all lipid-lowering treatment within 90 days. Those who stopped had rising LDL cholesterol and higher risk of every outcome than those continuing any.
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