Lower‐Intensity Statins Contributing to Gaps in Care for Patients With Primary Severe Hypercholesterolemia
| Autor: | Wael Eid, Joseph R. Nolan, Elijah Flerlage, Emma Hatfield Sapp |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Statin Epidemiology medicine.drug_class Hypercholesterolemia Familial hypercholesterolemia lipid‐lowering therapies Midwestern United States Coronary artery disease Risk Factors clinical inertia Cardiovascular Disease Internal medicine medicine electronic medical records Humans Diseases of the circulatory (Cardiovascular) system Preventive Cardiology Quality of Health Care Retrospective Studies Original Research familial hypercholesterolemia business.industry statin severe hypercholesterolemia Cholesterol LDL Lower intensity medicine.disease Primary Prevention estimated LDL‐C RC666-701 Cardiology lipids (amino acids peptides and proteins) Hydroxymethylglutaryl-CoA Reductase Inhibitors Cardiology and Cardiovascular Medicine business gaps in care |
| Zdroj: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 10, Iss 17 (2021) Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| ISSN: | 2047-9980 |
| Popis: | Background Although severe hypercholesterolemia confers a 5‐fold increased long‐term risk for coronary artery disease, treatment guidelines may not be fully implemented, leading to underdiagnosis and suboptimal treatment. To further understand the clinical features and gaps in treatment approaches, we analyzed electronic medical record data from a midwestern US multidisciplinary healthcare system, between 2009 and 2020. Methods and Results We retrospectively assessed the prevalence, clinical presentation, and treatment characteristics of individuals currently treated with statin therapy having a low‐density lipoprotein cholesterol (LDL‐C) value that is either (1) an actual maximum electronic medical record–documented LDL‐C ≥190 mg/dL (group 1, n=7542) or (2) an estimated pretreatment LDL‐C ≥190 mg/dL (group 2, n=7710). Comorbidities and prescribed lipid‐lowering therapies were assessed. Statistical analyses identified differences among individuals within and between groups. Of records analyzed (n=266 282), 7% met the definition for primary severe hypercholesterolemia. Group 1 had more comorbidities than group 2. More individuals in both groups were treated by primary care providers (49.8%–53.0%, 32.6%–36.4%) than by specialty providers (4.1%–5.5%, 2.1%–3.3%). High‐intensity lipid‐lowering therapy was prescribed less frequently for group 2 than for group 1, but moderate‐intensity statins were prescribed more frequently for group 2 (65%) than for group 1 (52%). Conclusions Two percent of patients in our study population being treated with low‐ or moderate‐intensity statins have an estimated LDL‐C ≥190 mg/dL (indicating severe hypercholesterolemia), but receive less aggressive treatment than patients with a maximum measured LDL‐C ≥190 mg/dL. |
| Databáze: | OpenAIRE |
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