Pargaonkar Kishor, Chaudhary Sanjeev, Roy Choudhury Arijit, Samaria Anil, Shendage Sudhir, Narayana Ganesh, Bhardwaj Ashootosh, Balachandran Anil, Bva Ranga Reddy, Sinh Puwar Pruthviraj, Kumar Nutan, Bansode Snehal, Pednekar Abhijit
Cardiology, Pargaonkar Hospital, Aurangabad, IND.
Cardiology, Marengo Asia Hospitals, Gurgaon, IND.
Cureus. 2025 Aug 6;17(8):e89471. doi: 10.7759/cureus.89471. eCollection 2025 Aug.
Background Medication adherence is mostly influenced by cost, and disease management can be achieved through cost-effective combinations. The present study aimed to evaluate adherence to the cost-effective fixed dose combination (FDC) of rosuvastatin and clopidogrel in the management of cardiovascular diseases (CVD). Methods This retrospective, non-randomized, non-comparative, multicenter study was conducted across 100 healthcare centers in India. Patients aged ≥18 years, of either sex, who were prescribed a combination of rosuvastatin and clopidogrel, and had a clinical diagnosis of atherosclerotic cardiovascular disease (ASCVD) or were post-acute coronary syndrome (ACS) or were at high risk for cardiovascular events, as determined by standard care practices in medicine and cardiology, were included in the study. Results A total of 975 patients were included in the study. Hypertension was the most common comorbidity observed in 749 (76.82%) patients, followed by diabetes in 706 (72.41%) patients. All patients received a clopidogrel dose of 75 mg. However, 492 (50.46%) patients were prescribed rosuvastatin 20 mg, while 483 (49.54%) patients received the 10 mg dose. Adherence to all prescribed doses was reported in 931 patients (95.49%). The most commonly reported reasons for treatment adherence with clopidogrel and rosuvastatin were decreased cost, reported by 672 patients (68.92%), and simplified dosing, reported by 589 patients (60.41%). Furthermore, 548 (56.21%) physicians rated the efficacy of a combination of clopidogrel and rosuvastatin as excellent, while 549 (56.31%) physicians rated its tolerability as excellent. Better adherence and treatment of dyslipidemia were significantly more common reasons for prescribing treatments among patients with an income of >10 lakh compared to those with an income of <5 lakh and five to 10 lakh (P=0.023 and P=0.047, respectively). The physician's global evaluations of both efficacy and tolerability were rated as "Excellent" significantly more commonly in patients receiving the 20 mg dose of rosuvastatin compared to those receiving the 10 mg dose (P=0.004 and P=0.028, respectively). Conclusion The combination of clopidogrel and rosuvastatin was well-tolerated, with high adherence in patients with ASCVD, post-ACS, and those at high cardiovascular risk.
药物依从性主要受成本影响，通过具有成本效益的联合用药可实现疾病管理。本研究旨在评估瑞舒伐他汀和氯吡格雷的成本效益固定剂量组合（FDC）在心血管疾病（CVD）管理中的依从性。
本回顾性、非随机、非对照、多中心研究在印度的100个医疗中心开展。纳入年龄≥18岁、性别不限、开具了瑞舒伐他汀和氯吡格雷联合用药处方、经医学和心脏病学标准护理实践判定患有动脉粥样硬化性心血管疾病（ASCVD）或为急性冠状动脉综合征（ACS）后或处于心血管事件高风险的患者。
共975例患者纳入研究。高血压是最常见的合并症，749例（76.82%）患者出现，其次是糖尿病，706例（72.41%）患者出现。所有患者均接受75mg氯吡格雷剂量。然而，492例（50.46%）患者开具了20mg瑞舒伐他汀处方，而483例（49.54%）患者接受10mg剂量。931例患者（95.49%）报告对所有规定剂量的依从性良好。氯吡格雷和瑞舒伐他汀治疗依从性最常报告的原因是成本降低，672例患者（68.92%）报告，以及给药简化，589例患者（60.41%）报告。此外，548例（56.21%）医生将氯吡格雷和瑞舒伐他汀联合用药的疗效评为优秀，而549例（56.31%）医生将其耐受性评为优秀。与收入<50万和50万至100万的患者相比，收入>100万的患者中，更好的依从性和血脂异常治疗是更常见的开药原因（分别为P=0.023和P=0.047）。与接受10mg剂量瑞舒伐他汀的患者相比，接受20mg剂量瑞舒伐他汀的患者中，医生对疗效和耐受性的总体评价显著更常被评为“优秀”（分别为P=0.004和P=0.028）。
氯吡格雷和瑞舒伐他汀联合用药耐受性良好，在ASCVD、ACS后及心血管高风险患者中具有高依从性。
