Investigators for a large prospective trial of lipid lowering therapy have recently assessed medication discontinuation during the study (IMPROVE-IT – Improved Reduction of Outcomes: Vytorin Efficacy International Trial, placebo+simvastatin vs ezetimibe+simvastatin for people hospitalized with acute coronary syndrome). Nearly half of all subjects discontinued study medication, with risk of discontinuation was highest in the trial but decreased with increasing time. Discontinuation was higher amongst those in the placebo+simvastatin arm, compared to those receiving ezetimibe+simvastatin, and was highest amongst people in the United States in this international study. Multivariate analysis revealed that smoking, prior revascularization, hypertension, unstable angina, female gender, non-white race, and US location were all factors associated with higher discontinuation rates. More information is available here