Abstract 11163: Lipid Monitoring and Treatment Intensification of Cholesterol Lowering Therapies - Insight From the Veterans Affairs Healthcare System
Introduction: The 2013 and 2018 Blood Cholesterol guidelines recommend monitoring of lipids to assess efficacy and adherence to cholesterol lowering therapy. Lipid testing provides clinical data that can guide statin titration or initiation of non-statin therapies.
Hypothesis: Lipid monitoring is associated with greater treatment intensification of cholesterol lowering therapy.
Methods: Patients from the Veterans Affairs (VA) healthcare system with atherosclerotic cardiovascular disease (ASCVD) and at least one primary care visit between October 2013 and September 2014 were included (n=1,061,753). Treatment intensification was defined as the initiation of a statin, an increase in the intensity or dose of statin therapy, or the addition of ezetimibe. The association between the number of lipid panels and treatment intensification was assessed using adjusted logistic regression models.
Results: During the study period, 87.1% of patients had at least 1 lipid panel performed. Those with at least 1 lipid panel were more likely to undergo treatment intensification during the study period compared with individuals with 0 lipid panels (9.3% vs 5.4% respectively, p<0.001). Among individuals who were not on a statin (n=287,636), those who had at least 1 lipid panel were more likely to be started on statin therapy compared to those without a lipid panel (21.5% vs 8.7%, p<0.001). In regression analysis, there was a graded positive association between the number of lipid panels and treatment intensification (Table).
Conclusions: In patients with ASCVD, guideline-recommended lipid monitoring may help facilitate treatment intensification of cholesterol lowering therapy.
Center for Cardiovascular Analytics, Research + Data Science (CARDS)
Jia, Xiaoming; Ramsey, David J.; al Rifai, Mahmoud; Ahmed, Sarah T.; Akeroyd, Julia M.; Dixon, Dave L.; Gluckman, Tyler J; Nambi, Vijay; Ballantine, Christie M.; Petersen, Laura A.; Stone, Neil J.; and Virani, Salim S., "Abstract 11163: Lipid Monitoring and Treatment Intensification of Cholesterol Lowering Therapies - Insight From the Veterans Affairs Healthcare System" (2019). Articles, Abstracts, and Reports. 3460.