1. Assessment of compliance with lipid guidelines in an academic medical center.
- Author
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Schwiesow SJ, Nappi JM, and Ragucci KR
- Subjects
- American Heart Association, Angioplasty, Balloon, Coronary, Cerebrovascular Disorders blood, Cerebrovascular Disorders therapy, Cholesterol, LDL standards, Clofibric Acid therapeutic use, Coronary Artery Bypass, Coronary Artery Disease blood, Coronary Artery Disease therapy, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use, Hypolipidemic Agents therapeutic use, Inpatients statistics & numerical data, Myocardial Infarction blood, Myocardial Infarction therapy, Niacin therapeutic use, Retrospective Studies, Societies, Medical organization & administration, Societies, Medical standards, Treatment Outcome, United States, Academic Medical Centers, Cholesterol, LDL blood, Guideline Adherence standards, Practice Guidelines as Topic standards
- Abstract
Background: The importance of achieving a low-density lipoprotein cholesterol (LDL-C) level less than 100 mg/dL in patients with coronary artery disease (CAD) or cerebrovascular disease (CVD) is well established. Emerging evidence supports the recognition and management of secondary lipid goals, high-density lipoprotein cholesterol (HDL-C) level greater than 40 mg/dL, and triglyceride level less than 150 mg/dL., Objective: To evaluate whether inpatient services within an academic setting were achieving/addressing primary and secondary lipid goals in patients with established CAD or CVD., Methods: Patients with a discharge diagnosis of acute myocardial infarction, myocardial revascularization procedures, and/or ischemic stroke were identified. A retrospective chart review was done to assess adherence to the American Heart Association (AHA)/American College of Cardiology (ACC) guidelines for lipid management., Results: On average, 63% of patients with CAD or CVD had a lipid panel assessed during their hospitalization. Of the patients who had a fasting lipid panel checked, only 40% (72/178) had an LDL-C level less than 100 mg/dL. Of those patients, only 31% (22) also had an HDL-C level greater than 40 mg/dL. Even fewer patients (24%; 17) met both primary and secondary goals. Of the 287 patients included in the study, 69% (199) were prescribed a statin, 3% (9) a fibrate, and 3% (8) niacin on discharge., Conclusions: Few patients with CAD or CVD met the AHA/ACC goals for lipid management, yet a significant number were not prescribed appropriate lipid-lowering therapy at discharge. This finding strongly suggests that more awareness in this area is needed.
- Published
- 2006
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