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Lipid management in contemporary community practice: Results from the Provider Assessment of Lipid Management (PALM) Registry.

Publication ,  Journal Article
Navar, AM; Wang, TY; Li, S; Robinson, JG; Goldberg, AC; Virani, S; Roger, VL; Wilson, PWF; Elassal, J; Lee, LV; Peterson, ED
Published in: American heart journal
November 2017

The latest cholesterol guidelines have shifted focus from achieving low-density lipoprotein cholesterol (LDL-C) targets toward statin use and intensity guided by atherosclerotic cardiovascular disease (ASCVD) risk.Statin use and intensity were evaluated in 5,905 statin-eligible primary or secondary prevention patients from 138 PALM Registry practices.Overall, 74.7% of eligible adults were on statins; only 42.4% were on guideline-recommended intensity. Relative to primary prevention patients, ASCVD patients were more likely to be on a statin (83.6% vs 63.4%, P<.0001) and guideline-recommended intensity (47.3% vs 36.0%, P<.0001). Men were more likely than women to be prescribed recommended intensity for primary (odds ratio [OR] 1.87, 95% CI 1.49-2.34) and secondary (OR 1.47, 95% CI 1.26-1.70) prevention. In primary prevention, increasing age, diabetes, obesity, hypertension, and lower 10-year ASCVD risk were associated with increased odds of receiving recommended intensity. Among ASCVD patients, those with coronary artery disease were more likely to be on recommended intensity than cerebrovascular or peripheral vascular disease patients (OR 1.71, 95% CI 1.41-2.09), as were those seen by cardiologists (OR 1.43, 95% CI 1.12-1.83). Median LDL-C levels were highest among patients not on statins (124.0 mg/dL) and slightly higher among those on lower-than-recommended intensity compared with recommended-therapy recipients (88.0 and 84.0 mg/dL, respectively; P≤.0001).In routine contemporary practice, 1 in 4 guideline-eligible patients was not on a statin; less than half were on the recommended statin intensity. Untreated and undertreated patients had significantly higher LDL-C levels than those receiving guideline-directed statin treatment.

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Published In

American heart journal

DOI

EISSN

1097-6744

ISSN

0002-8703

Publication Date

November 2017

Volume

193

Start / End Page

84 / 92

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Secondary Prevention
  • Risk Factors
  • Retrospective Studies
  • Registries
  • Primary Prevention
  • Primary Health Care
  • Male
  • Lipids
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Navar, A. M., Wang, T. Y., Li, S., Robinson, J. G., Goldberg, A. C., Virani, S., … Peterson, E. D. (2017). Lipid management in contemporary community practice: Results from the Provider Assessment of Lipid Management (PALM) Registry. American Heart Journal, 193, 84–92. https://doi.org/10.1016/j.ahj.2017.08.005
Navar, Ann Marie, Tracy Y. Wang, Shuang Li, Jennifer G. Robinson, Anne C. Goldberg, Salim Virani, Veronique L. Roger, et al. “Lipid management in contemporary community practice: Results from the Provider Assessment of Lipid Management (PALM) Registry.American Heart Journal 193 (November 2017): 84–92. https://doi.org/10.1016/j.ahj.2017.08.005.
Navar AM, Wang TY, Li S, Robinson JG, Goldberg AC, Virani S, et al. Lipid management in contemporary community practice: Results from the Provider Assessment of Lipid Management (PALM) Registry. American heart journal. 2017 Nov;193:84–92.
Navar, Ann Marie, et al. “Lipid management in contemporary community practice: Results from the Provider Assessment of Lipid Management (PALM) Registry.American Heart Journal, vol. 193, Nov. 2017, pp. 84–92. Epmc, doi:10.1016/j.ahj.2017.08.005.
Navar AM, Wang TY, Li S, Robinson JG, Goldberg AC, Virani S, Roger VL, Wilson PWF, Elassal J, Lee LV, Peterson ED. Lipid management in contemporary community practice: Results from the Provider Assessment of Lipid Management (PALM) Registry. American heart journal. 2017 Nov;193:84–92.
Journal cover image

Published In

American heart journal

DOI

EISSN

1097-6744

ISSN

0002-8703

Publication Date

November 2017

Volume

193

Start / End Page

84 / 92

Related Subject Headings

  • Treatment Outcome
  • Time Factors
  • Secondary Prevention
  • Risk Factors
  • Retrospective Studies
  • Registries
  • Primary Prevention
  • Primary Health Care
  • Male
  • Lipids