Abstract
Abstract 4145340: Health System Variability in Lipid Management for Patients with Atherosclerotic Cardiovascular Disease: An Analysis from Cv-MOBIUS
Circulation (New York, N.Y.), Vol.150(Suppl_1)
11/12/2024
DOI: 10.1161/circ.150.suppl_1.4145340
Abstract
Abstract only Background: Nationally, many ASCVD patients fail to achieve an LDL-C <70 mg/dL, and uptake of both statin and non-statin therapies is low. The degree to which this varies across health systems is less clear. Methods: A cross sectional analysis was performed where lipid levels and lipid lowering therapies (LLT) were assessed using electronic health record data in patients with a previous diagnosis of ASCVD. The data was obtained across 14 US healthcare systems between 1/1/2021-12/31/2022. Proportions of patients with an active prescription of any statin, high intensity statin, ezetimibe, PCSK9i, and combination therapy (two or more agents) within 395 days of the most recent LDL-C value (index date) was evaluated overall and by participating site. Additionally, the proportion of patients with an LDL-C <70 mg/dL at the index date was also assessed. Results: Across 14 health systems, 1,118,623 patients with ASCVD were identified (median 61,840 per health system, range 8,161-182,315). Overall, 675,776 (60.4%) had an LDL-C level in the past year (range 39.1% - 70.8%). Of those with a lipid level, achievement of LDL-C <70 mg/dL ranged from 34.6-47.2%. In total, 42.6% were on any statin, 20.1% were on a high intensity statin, 4.3% on ezetimibe, and 1.2% on a PCSK9i. Only 2.9% were on combination therapy of a statin with ezetimibe or a PCSK9i. Variability was seen across health systems in utilization of each of these therapies, however even in the highest performing health systems, LLT uptake and achievement of LDL-C < 70mg/dL remained low ( Figure). Conclusion: Variability in utilization of LLT in ASCVD patients between health systems suggests that system-level factors may impact achieving guideline-based LDL-C goals. Despite the variability, the highest proportion of patients achieving an LDL-C <70mg/dL remained under 50% indicating the need for aggressive implementation efforts.
Details
- Title: Subtitle
- Abstract 4145340: Health System Variability in Lipid Management for Patients with Atherosclerotic Cardiovascular Disease: An Analysis from Cv-MOBIUS
- Creators
- Nishant Shah - Duke Medical CenterPeter Shrader - Duke Medical CenterSatoshi Shoji - Keio UniversitySeth Martin - Johns Hopkins UniversitySoledad Fernandez - The Ohio State UniversityAlanna Chamberlain - Mayo ClinicJonathan Arnold - UPMC McKeesportMichael Shapiro - Wake Forest UniversityMark Effron - Ochsner Medical CenterElizabeth Chrischilles - University of IowaClint Allred - Saint Luke's Health SystemElisa Priest - Baylor Medical Center at GarlandMahanaz Syed - Audie L. Murphy Memorial VA HospitalH Lester Kirchner - Geisinger Medical CenterMonika Leja - University of Michigan–Ann ArborZahid Ahmad - The University of Texas Southwestern Medical CenterBethany Kalich - AmgenNafeesa Dhalwani - AmgenLaney Jones - AmgenCezary Wojcik - AmgenEric Peterson - The University of Texas Southwestern Medical CenterAnn Marie Navar - The University of Texas Southwestern Medical Center
- Resource Type
- Abstract
- Publication Details
- Circulation (New York, N.Y.), Vol.150(Suppl_1)
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS; PHILADELPHIA
- DOI
- 10.1161/circ.150.suppl_1.4145340
- ISSN
- 0009-7322
- eISSN
- 1524-4539
- Language
- English
- Date published
- 11/12/2024
- Academic Unit
- Epidemiology; Pharmacy
- Record Identifier
- 9984749759402771
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