Variation in Lipid Management for Atherosclerotic Cardiovascular Disease Across US Health Systems
Authors' conclusion
Despite variability in lipid management resources and lipid-lowering therapy use across systems, many did not reach an LDL-C <70 mg/dL, and there was low uptake of lipid-lowering therapy. Innovative implementation strategies are needed for system-level lipid management.
Study context
- Population
- Patients with atherosclerotic cardiovascular disease across US academic health systems, January 1, 2021, to December 31, 2023patients with atherosclerotic cardiovascular disease, median, 88,365 per system, range, 17,086–2 48,371 · with an LDL-C level available 890,521
- Participants
- 1,738,042 patients
- Comparison
- System-level association between an LDL-C <70 mg/dL and the presence of lipid management programs, and whether system-level uptake of statin or nonstatin lipid-lowering therapy was associated with an LDL-C <70 mg/dL
- Outcome
- Health systems with prevention or lipid clinics
Methodological details16 US academic health systems, sequential multilevel multivariable logistic regression
- 16 US academic health systems
- Sequential multilevel multivariable logistic regression
Main finding
As reported in the abstract
Health systems with prevention or lipid clinics
About 81%
Further findings
Statin use across health systems
- Range
- 31.0% to 60.4%
- Median
- 46.3%
Use of high-intensity statins, nonstatins, and combination lipid-lowering therapy
- High-intensity statins
- 16.2%-33.1%
- Nonstatins
- 2.6%-8.1%
- Combination lipid-lowering therapy
- 1.7%-6.3%
LDL-C <70 mg/dL among those with an LDL-C level available
- Among those with an LDL-C level available (n=890 521)
- 42.5%
- Range across systems
- 35.8% to 49.4%
Association of LDL-C <70 mg/dL with lipid management algorithm, prevention clinics/lipid clinics, or electronic health record-based tools
- No association
Association of system-level high-intensity statin utilization or nonstatin use with LDL-C <70 mg/dL
- Not associated
Original publication
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