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Repeat Lipid Testing in CHD

Repeat Lipid Testing in CHD

For patients with coronary heart disease (CHD), current performance measures recommend annual lipid testing, followed by treatment intensification in cases when abnormal lipid levels are spotted. Little is known, however, about the frequency and correlates of repeat lipid testing in patients with CHD who have already attained guideline–recommended LDL-cholesterol (LDL-C) treatment targets and receive no treatment intensification. “In these patients, repeat lipid testing may represent health resource overuse and possible waste of healthcare resources,” says Salim S. Virani, MD, PhD. Intriguing New Findings on Repeat Lipid Testing In JAMA Internal Medicine, Dr. Virani and colleagues had an analysis published that sought to determine the frequency and correlates of repeat lipid testing in patients with CHD who have already attained the guideline-recommended LDL-C target of less than 100 mg/dL and received no further treatment intensification. Among 27,947 patients with LDL-C less than 100 mg/dL, the data showed that 9,200 patients (32.9%) had another repeat lipid panel performed at 11 months from their first lipid panel in the absence of any treatment intensification. “Overall, about one-third of patients with CHD continued to undergo lipid testing after they achieved their LDL-C goal without treatment intensification,” says Dr. Virani. “More than 9,000 patients had additional lipid panels in the 11 months after they achieved an LDL-C target of less than 100 mg/dL in the absence of any further treatment intensification (which could be performed to attain the optional treatment target of LDL-C less than 70 mg/dL). About two-thirds of patients in our analysis who also met the optional LDL-C treatment target of less than 70 mg/dL had repeat lipid testing within 11 months...

Attaining LDL Cholesterol Goals After AMI

One-third of patients with acute myocardial infarction (AMI) and baseline hyperlipidemia do not appear to reach an LDL cholesterol (LDL-C) goal of less than 100 mg/dL after 6 months, according to American research. Patients who did not meet the LDL-C goal during this timeframe were more often discharged without a statin than those who attained the goal (21% vs 9%). Abstract: American Heart Journal, January...

Conference Highlights: ACC.12

New research was recently presented at ACC.12, the annual scientific meeting of the American College of Cardiology, from March 24-27 in Chicago. The features below highlight just some of the studies that emerged from the meeting. Angioplasty Safe at Community Hospitals Should LDL Be Targeted Early in Life? Improving BP Control With Telemedicine A Checklist to Reduce HF Readmissions Visualization Encourages Statin Adherence & Lifestyle Changes Improving the Quality of ACS Care Angioplasty Safe at Community Hospitals The Particulars: Community hospitals without cardiac surgery units have traditionally performed angioplasties only in emergency situations. Patients needing elective angioplasty have typically been transferred to hospitals with on-site cardiac surgery units. A recent guideline from the American College of Cardiology and American Heart Association questioned the need for such transfers. Data Breakdown: In a study, nearly 19,000 patients were randomized to undergo elective angioplasty at a facility with on-site cardiac surgery or at one of 60 community hospitals that had undergone special preparations to perform angioplasty. No differences were observed in death rates between the two facility types. Furthermore, no significant differences were seen in rates of complications, such as bleeding, renal failure, and stroke. Take Home Pearl: With appropriate preparation, community hospitals without on-site cardiac surgery units appear to have the capability to safely and effectively perform elective angioplasty. Should LDL Be Targeted Early in Life? The Particulars: Patients with high LDL cholesterol often do not begin treatment to lower their LDL levels until after coronary heart disease (CHD) has been quietly developing for years. Coronary atherosclerosis begins early in life. It has been hypothesized that lowering LDL at a younger...
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