Prevalence and predictors of clinically significant statin–drug interactions among Yemeni patients taking statins for primary and secondary prevention of cardiovascular disease

Abstract

Background

Statins are extensively used in clinical practice for the primary and secondary prevention of cardiovascular diseases. Statins are usually taken in combination with other medications. This may increase the risk of statin-drug interactions. The study aimed to evaluate the prevalence, patterns, and predictors of clinically significant statin-drug interactions among patients on statin therapy.

Material and Methods

A cross-sectional study was conducted at the cardiology, endocrine, and internal medicine outpatient clinics in four tertiary care hospitals in Sana’a, Yemen. Lexicomp Drug Interaction database was used to analyze the prescriptions for potential statin-drug interactions. Binary and multivariable logistic regression were utilized for analysis.

Results

Of the total number of patients (634), 114 individuals (18%) had a total of 122 statin-drug interactions. According to Lexicomp risk classification, 102 (83.6%) DDIs were class C (monitor therapy), 19 (15.6%) were class D (therapy modification), and only one (0.8%) class X (avoid combination). Simvastatin use was significantly associated with the presence of category D and X DDIs (15.9% vs. 1.6%, p < .001). Polypharmacy (OR = 2.571, p < .001) and having ≥3 comorbidities (OR = 2.512, p < .001) were the only variables associated with the presence of statin-drug interactions (C, D, and/or X).

Conclusion

Patients with polypharmacy and those with three or more comorbidities had a higher risk for statin-drug interactions. Therefore, routine screening by physicians and pharmacists for potential interactions should occur before prescribing or dispensing any medication to avoid clinically significant statin-drug interactions.

Keywords:

• Statins
• drug-drug interactions
• Lexicomp
• statins safety
• polypharmacy
• drug-related problems

Transparency

Declaration of funding

This manuscript received no funding.

Declaration of financial/other relationships

The authors have no conflicts of interest for this study. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgements

The authors are grateful to all the patients who participated in this study. We would also like to thank ProfPhamra initiative team Asia Mohammed Alantari and Atef Abdulmajeed Al-Saman for their assistance in data collection.