Author + information
- Tracy Wang,
- Shuang Li,
- Ann Marie Navar,
- Veronique Roger,
- Jennifer Robinson,
- Anne Goldberg,
- Salim Virani,
- Joseph Elassal,
- L. Veronica Lee,
- Peter Wilson and
- Eric Peterson
Background: 2013 ACC/AHA guidelines recommend LDL-C testing to assess statin candidacy and adherence. In practice, how often and in which patients lipid testing is currently performed are unknown.
Methods: PALM Registry enrolled patients with or at risk of ASCVD from 140 U.S. cardiology and primary care clinics in 2015. Sites reviewed medical records to collect lipid levels within 2 years pre-enrollment. Study core labs drawn at enrollment assessed current lipid levels.
Results: Pre-enrollment, 4840/7627 (63%) patients had clinician-ordered lipid testing; cardiologists were no more likely to test than other providers (64% vs. 63%, p=0.34). Patients without lipid testing were more often female (49% vs. 46%), non-white (22% vs. 11%), and non-college graduates (39% vs. 32%); all p<0.01. Among adults recommended for a statin, 40% not on a statin and 36% on a statin but underdosed per guidelines had no lipid measures in the past 2 years. Core labs identified 166 adults with LDL-C ≥190 mg/dL at enrollment; 36% of which had no prior LDL-C measures. Despite statin therapy, core lab LDL-C was ≥100 in 43% of primary prevention and 26% of ASCVD patients. Among primary prevention adults on statins, prior LDL-C testing was associated with higher likelihood of core lab LDL-C <100 (Table).
Conclusions: Lipid testing is not done in >1/3 of high-risk patients in current practice. Lipid testing can optimize statin use and dosing per guidelines, as well as identify statin users who are nonadherent or need more intense lipid lowering.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Advances in Cholesterol Measurement and Management
Abstract Category: 32. Prevention: Clinical
Presentation Number: 1106-041
- 2017 American College of Cardiology Foundation