BACKGROUND Not all patients recovering from acute myocardial infarction (AMI) are optimally treated with statin, and their adherence to statin treatment may be inadequate. We set out to describe changes in statin treatment adherence and cholesterol values over time. METHODS Data from two cohorts of AMI patients discharged from the Department of Cardiology, Odense University Hospital, in 2003 (n = 474, mean age 68 years, 66% males) and 2008 (n = 550, mean age 67 years, 69% males) were compared. Based on the number of tablets collected at the pharmacy, patients' adherence to statin treatment in a period of two years after discharge was analysed. Patients were considered adherent when in possession of medication ≥ 80% of the period. From the day of admission and at follow-up, cholesterol values and the relative number of patients with a total-cholesterol < 4.5 mmol/l were calculated. RESULTS A significant improvement in statin adherence was noted: 42% versus 75% (p < 0.0001). The most significant difference was observed in patients ≥ 80 years, who improved from 25% to 72% (p < 0.0001). Furthermore, an overall significant reduction in follow-up cholesterol levels was observed: from 4.4 to 4.2 mmol/l (p = 0.003). More-over, an increase was observed in the proportion of patients with a follow-up cholesterol value < 4.5 mmol/l: from 57% to 67% (p = 0.001). The most significant changes were demonstrated in patients ≥ 70 years. CONCLUSIONS Over the five-year period from 2003 to 2008, statin adherence and cholesterol values significantly improved. However, room for improvement remains, particularly in younger patients. BACKGROUND not relevant. BACKGROUND not relevant.