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Treatment and Low-Density Lipoprotein Cholesterol Management in Patients Diagnosed With Clinical Atherosclerotic Cardiovascular Disease in Alberta

Published on Jul 1, 2019in Canadian Journal of Cardiology 5.59
· DOI :10.1016/j.cjca.2019.04.008
Guanmin Chen12
Estimated H-index: 12
(Libin Cardiovascular Institute of Alberta),
Megan Farris + 6 AuthorsTodd J. Anderson45
Estimated H-index: 45
(Libin Cardiovascular Institute of Alberta)
Abstract Background Low-density lipoprotein cholesterol (LDL-C) is an important indicator in the development and management of atherosclerotic cardiovascular disease (ASCVD). Herein, we describe the management of LDL-C with lipid-lowering therapy, among patients diagnosed with clinical ASCVD in Alberta, Canada. Methods A retrospective study was conducted by linking multiple health system databases to examine clinical characteristics, treatments, and LDL-C assessments. Patients with ASCVD were identified using a specific case definition on the basis of International Classification of Diseases, Ninth Revision, Clinical Modification/International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Canada codes between 2011 and 2015. LDL-C was assessed at the first measurement (index test) and second measurement (follow-up test) during the study period. LDL-C levels were evaluated on the basis of the 2016 Canadian Cardiovascular Society guideline recommendations for achieving Results Among the 281,665 individuals identified with ASCVD during the study period, 219,488 (77.9%) had an index LDL-C test, whereas 120,906 (55.1%) and 144,607 (65.9%) were prescribed lipid-lowering therapy before and after their index test, respectively. Most patients who received any lipid-lowering therapy were receiving moderate-/high-intensity statins (n = 133,029; 60.6%). Among the study cohort who had 2 LDL-C tests (n = 91,841; 32.6%), 48.5% of patients who received any lipid-lowering therapy did not achieve LDL-C levels Conclusions The current study revealed that only two-thirds of patients with ASCVD were receiving pharmacotherapy and of those, a significant proportion did not reach recommended LDL-C levels. A remarkable treatment gap was identified for at-risk ASCVD patients. Further implementation strategies are required to address this undermanagement.
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  • Citations (1)
Published on Aug 1, 2018in Cardiovascular Drugs and Therapy 4.18
Teresa N. Harrison10
Estimated H-index: 10
(KP: Kaiser Permanente),
Ronald D. Scott2
Estimated H-index: 2
(WLAC: West Los Angeles College)
+ 7 AuthorsKristi Reynolds28
Estimated H-index: 28
(KP: Kaiser Permanente)
Purpose Implementation of the 2013 ACC/AHA cholesterol treatment guideline is likely to vary by statin benefit group. The aim of this study was to document trends in statin use before and after introduction of the ACC/AHA guideline.
Published on Mar 4, 2018in Current Medical Research and Opinion 2.35
Dasha Cherepanov16
Estimated H-index: 16
Tanya Gk Bentley9
Estimated H-index: 9
+ 5 AuthorsDavid O. Beenhouwer13
Estimated H-index: 13
AbstractObjective: Based on randomized controlled trials (RCTs), non-fatal myocardial infarction (MI) rates range between 9 and 15 events per 1000 person-years, ischemic stroke between 4 and 6 per 1000 person-years, CHD death rates between 5 and 7 events per 1000 person-years, and any major vascular event between 28 and 53 per 1000 person-years in patients with atherosclerotic cardiovascular disease (ASCVD). We reviewed global literature on the topic to determine whether the real-world burden of...
Published on Nov 1, 2017in Current Atherosclerosis Reports 3.77
M. Leya1
Estimated H-index: 1
(NU: Northwestern University),
Neil J. Stone40
Estimated H-index: 40
(NU: Northwestern University)
Purpose of Review Our aim was to examine the current evidence behind prescribing statins to individuals over 65 years of age with emphasis on those older than 75. Individuals over 75 years of age may often have multiple comorbidities and take many medications. Additionally, they are often underrepresented in randomized controlled trials (RCTs) of statins in older populations. While results of RCTs demonstrate the benefit of statin therapy in both primary and secondary prevention patients, clinic...
Published on Jun 3, 2017in Journal of Medical Economics
Peter P. Toth38
Estimated H-index: 38
(JHUSOM: Johns Hopkins University School of Medicine),
Mark D. Danese22
Estimated H-index: 22
+ 4 AuthorsJeroen P. Jansen31
Estimated H-index: 31
(Precision Health Economics)
AbstractAim: To estimate real-world cardiovascular disease (CVD) burden and value-based price range of evolocumab for a US-context, high-risk, secondary-prevention population.Materials and methods: Burden of CVD was assessed using the UK-based Clinical Practice Research Datalink (CPRD) in order to capture complete CV burden including CV mortality. Patients on standard of care (SOC; high-intensity statins) in CPRD were selected based on eligibility criteria of FOURIER, a phase 3 CV outcomes trial...
Published on May 1, 2017in Canadian Journal of Cardiology 5.59
Christopher Naugler13
Estimated H-index: 13
(U of C: University of Calgary),
Charles Cook + 4 AuthorsTodd J. Anderson45
Estimated H-index: 45
(Libin Cardiovascular Institute of Alberta)
Abstract Low rates of cardiovascular preventive therapy with statin medications is a significant public health problem in Canada. There is a pressing need for public health interventions to increase the use of statin medications, especially among high-risk patients. In this article, we present the results of a quality assurance pilot program to provide laboratory-reported Framingham Risk Score (FRS) to physicians. This work was performed in a mixed urban and rural setting in southern Alberta. We...
Published on Mar 7, 2017in Circulation 23.05
Emelia J. Benjamin150
Estimated H-index: 150
Michael J. Blaha50
Estimated H-index: 50
+ 42 AuthorsCathleen Gillespie41
Estimated H-index: 41
Published on Mar 1, 2017in Canadian Journal of Cardiology 5.59
Jack V. Tu78
Estimated H-index: 78
(U of T: University of Toronto),
Anam M. Khan1
Estimated H-index: 1
+ 1 AuthorsAnna Chu8
Estimated H-index: 8
Abstract Background It is unknown how the contemporary burden of atherosclerotic cardiovascular disease (ASCVD) compares with historical trends. Methods As part of the Cardiovascular Health in Ambulatory Care Research Team "big data" initiative, we used information from multiple population-based databases to study 20-year temporal trends in hospitalizations and deaths from ASCVD. We calculated hospitalization rates for 6 ASCVD events (acute myocardial infarction, unstable angina, stroke, transie...
Published on Mar 1, 2017in Canadian Journal of Cardiology 5.59
Mostafa Alabousi5
Estimated H-index: 5
(U of O: University of Ottawa),
Peri Abdullah2
Estimated H-index: 2
(York University)
+ 7 AuthorsJacob A. Udell22
Estimated H-index: 22
Abstract Background Comparative cardiovascular risk factor care across North America is unknown. We aimed to determine current performance in Canada and the United States (US). Methods A systematic review was conducted of Medline and EMBASE (to June 1, 2014). Eligible studies reported on screening, awareness, treatment, or control rates for hypertension, dyslipidemia, diabetes, and smoking. Categorical performance ‘ratings' on the basis of the most successful US health plans were used to classif...