Abstract 12960: Identifying Gaps in Practice Patterns for Routine Lipid Profiles and High-Intensity Statins in Acute Myocardial Infarction Patients Prior to an Acute Coronary Syndrome Event

Le résumé fourni par la source

Introduction: According to the 2004 Guidelines for the Management of Patients With ST-Elevation Myocardial Infarction, admitting orders for the patient with STEMI should include a serum lipid profile in laboratory tests. Subsequently, the 2018 Guideline on the Management of Blood Cholesterol guidelines state that in primary prevention statins are recommended for patients with severe hypercholesterolemia and in adults 40 to 75 years of age either with diabetes mellitus or at higher ASCVD risk. Methods: A baseline review of data from Get With The Guidelines® - CAD across 10 pilot sites was conducted. An initial 430 patients were excluded from the Ezetimibe Considered for Very High-Risk Patients measure due to missing data fields. Interviews were conducted with participating sites to determine the root cause of the incomplete data. Results: The root cause analyses resulting from these interviews and case studies revealed that lipid profiles were not consistently performed. Further, only two patients were included in the numerator for the Ezetimibe Considered for Very High-Risk Patients measure. An analysis of 455 eligible patients showed that 70% of AMI patients seen by these hospitals were not presenting on any statin therapy prior to their acute event. Conclusions: Despite the clinical guideline recommendations for lipid management for both acute and secondary prevention, there remains much room for improvement. Preliminary results from this learning collaborative highlight the need for improved lipid profiling practices in the acute setting for STEMI patients and an opportunity for intervention through modifiable risk factor reduction in the form of statin therapy in the outpatient setting. We have identified a gap in AMI patient care, which presents the opportunity to improve long-term patient outcomes through heightened lipid profile collection sensitivity. At a systemic level, further research needs to be conducted to determine why patients are presenting with severe acute coronary events without prior management of their blood cholesterol levels. We hope through continued studies with the pilot sites we will observe a shift in practice patterns and improved non-statin lipid-lowering medication consideration for very high-risk ASCVD patients.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.