OBJECTIVES: To examine statin adherence and LDL-C targeted treatment goals (TTGs) among TRICARE beneficiaries receiving treatment for secondary prevention of coronary heart disease (CHD) at US Military Treatment Facilities (MTFs). METHODS: Retrospective cohort database study examining TRICARE beneficiaries 18-75 years of age, receiving medical services for a primary CHD event at an MTF between Jan-1-2004 and Dec-31-2008. Of the 20,658 MTF patients receiving statin-therapy for CHD, 3,676 had an LDL-C value recorded during subsequent 6-month (M6), 12-month (M12) and 18-month (M18) periods. TTGs were defined using ATPIII-NCEP Guidelines (i.e., LDL-C value<100mg/dL). Drug adherence was measured using the Medication Possession Ratio (MPR) at M6,M12, and M18. Persistence was measured as time to >35-day refill gap. Covariates included age, gender, beneficiary status, comorbidities, statin switching, dosage titrations and other lipid lowering therapies. Logistic and Cox regressions were conducted to assess predictors of TTG and adherence/persistence. RESULTS: The CHD cohort was 75% male, mean age 58.8 (SD=9.3) years. The percent of patients adherent (MPR>0.80) with statin-therapy was 85% at M6, 79% at M12, and 78% at M18. Older diabetic patients were more adherent and at TTG. Adjusting for covariates, adherent patients were more likely to be at TTG in M6,M12, and M18 (OR=1.98[1.62-2.42], 2.69[2.25-3.22], and 2.93[2.44-3.52], respectively). Overall mean persistence to statins was 330 (SD=199) days. Approximately 68% of patients were persistent at M6, 50% at M12, and 37% at M18. Patients at TTG were less likely to experience a gap in therapy at M6,M12, and M18 (HR=0.83[0.78-0.89],0.80[0.76-0.84], and 0.80[0.77-0.84]). CONCLUSIONS: This study showed a positive link between statin adherence and TTGs among secondary prevention patients with frequent LDL-C monitoring in the MHS. Patients with better adherence to statin-therapy were more likely to be at TTG, compared to non-adherent patients. Further study is needed to assess generalizability to all MHS secondary prevention patients.