Additional KIF6 Risk Offers Better Adherence to Statins

Coronary Heart Disease (CHD) remains a significant problem in the US, causing about 1 of every 5 deaths in 2005. In 2009, approximately 1.3 million Americans will have a new/recurrent myocardial infarction. Coronary heart disease (CHD) includes myocardial infarction, stable or unstable angina, demonstrated myocardial ischemia detected by noninvasive testing, and a history of coronary artery procedures (such a stent or bypass). Currently, "statins" are recommended by the AHA to manage elevated low-density lipoprotein-cholesterol (LDL-C). Unfortunately, the discontinuation of statins is quite substantial. For example, a large cohort study of older patients found that 2-year statin adherence rates were approximately 40% for acute coronary syndrome patients, 36% for chronic coronary artery disease, and 25% for primary prevention and is associated with increased mortality, hospitalizations, and costs. Recently, the kinesin 6 (KIF6) gene has been associated with a 30-55% increase in cardiovascular events in individuals carrying one or two risk variants (~57% of the white population) in multiple prospective studies. Furthermore, KIF6 carriers receiving a "statin" have a substantial greater cardiovascular risk reduction (-34 to 50%) when using a "statin" compared to those that are non-carriers using a statin (6 to 20%). In this prospective, open label, trial, recruited subjects recently started on statin therapy will be provided information about their KIF6 carrier status and followed for 6 months to determine their "statin" adherence. Additionally, quality of life and factors adherence will be measured at baseline and after 6 months. Finally, pharmacy records will be evaluated for up to 1-year to determine statin discontinuation rates.

Inclusion criteria

• Men and women at least 18 years of age
• New statin prescription
• Medco RationalMed® Program
• Data contains patient contact information (e.g. phone number)
• Data contains provider contact information
• Willing to sign informed consent and send KIF6 test results to their provider

Exclusion criteria

• Statin prescription in the previous 6 months
• Subject refusal to participate in this study (record reason from subject)
• Physician refusal to participate in this study (record reason from provider)
• Anticipated statin discontinuation within 6 months
• Any condition that would prevent the subject from completing the 6 month study follow-up period
• Subject with "no contact red flag"
• Subject residing in NY, NJ, MA, PA