Temporal patterns of lipid testing and statin therapy in acute coronary syndrome patients (from the canadian grace experience)
The American Journal of Cardiology,  Clinical Article

Elbarouni B et al. – There has been a significant temporal increase in the use of in–hospital statin therapy but only a minor increase in lipid testing. Lipid testing was strongly associated with in–hospital statin use. A substantial proportion of patients with acute coronary syndrome (ACS), especially those at higher risk, still do not receive these guideline–recommended interventions in contemporary practice.

Methods
  • Current guidelines recommend the measurement of fasting lipid profile and use of statins in all patients with acute coronary syndrome (ACS).
  • However, the temporal trends of lipid testing and statin therapy in “real–world” patients with ACS are unclear.
  • From January 1999 through December 2008, the prospective, multicenter, Global Registry of Acute Coronary Events (GRACE/GRACE2/CANRACE) enrolled 13,947 patients with ACS in Canada.
  • Authors stratified the study population based on year of presentation into 3 groups (1999 to 2004, 2005 to 2006, and 2007 to 2008) and compared the use of lipid testing and use of statin therapy in hospital.
  • Overall, 70.8% of patients underwent lipid testing and 79.4% received in–hospital statin therapy; these patients were younger and had lower GRACE risk scores (p <0.001 for the 2 comparisons) compared to those who did not.

Results
  • Over time there was a significant increase in rates of in–hospital statin therapy (70% in 1999 to 2004 to 84.5% in 2007 to 2008, p for trend < 0.001) but only a minor increase in rates of lipid testing (69.4% in 1999 to 2004 to 72.4% in 2007 to 2008, p for trend = 0.003).
  • After adjusting for confounders, this increasing temporal trend remained statistically significant for statin therapy (p <0.001) but not for lipid testing.
  • Lipid testing was independently associated with in–hospital statin use (adjusted odds ratio 1.62, 95% confidence interval 1.27 to 2.08, p <0.001).
  • In patients who did have lipid testing, those with low–density lipoprotein cholesterol level >130 mg/dl (3.4 mmol/L) were more likely to be treated with in–hospital statins.

Please login or register to follow this author.
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Internal Medicine

See All >> Messages include industry-sponsored communications and special communications from MDLinx

<

Most Popular Internal Medicine Articles

1 Acupuncture for chronic knee pain: a randomized clinical trial JAMA, October 1, 2014    Evidence Based Medicine    Clinical Article

2 Calcium and phosphorus intake and prostate cancer risk: A 24-y follow-up study American Journal of Clinical Nutrition, November 26, 2014    Clinical Article

3 Effects of tea intake on blood pressure: A meta-analysis of 21 randomized controlled trials JACC - Journal of the American College of Cardiology, October 22, 2014    Clinical Article

4 Vitamin D and Calcium Supplementation to Prevent Fractures in Adults: U.S. Preventive Services Task Force Recommendation Statement Full Text Annals of Internal Medicine, February 26, 2013    Free full text    Clinical Guideline

5 Aggressive risk factor reduction study for atrial fibrillation and implications for the outcome of ablation: The ARREST-AF cohort study JACC - Journal of the American College of Cardiology, December 3, 2014    Evidence Based Medicine    Clinical Article

6 The impact of phlebotomy in nonalcoholic fatty liver disease: A prospective randomized controlled trial Hepatology, December 24, 2014    Clinical Article

7 Sweetened carbonated beverage consumption and cancer risk: Meta-analysis and review European Journal of Cancer Prevention, August 1, 2014    Evidence Based Medicine    Review Article

8 Liberal versus restrictive blood transfusion strategy: 3-year survival and cause of death results from the FOCUS randomised controlled trial The Lancet, December 11, 2014    Evidence Based Medicine    Clinical Article

9 Cytisine versus nicotine for smoking cessation New England Journal of Medicine, December 18, 2014    Evidence Based Medicine    Clinical Article

10 P2X3 receptor antagonist (AF-219) in refractory chronic cough: a randomised, double-blind, placebo-controlled phase 2 study The Lancet, December 2, 2014    Evidence Based Medicine    Clinical Article

11 Avoidance of sun exposure is a risk factor for all-cause mortality: results from the MISS cohort Journal of Internal Medicine, April 22, 2014    Evidence Based Medicine    Clinical Article

12 Effect of metformin on left ventricular function after acute myocardial infarction in patients without diabetes: The GIPS-III randomized clinical trial Full Text JAMA, April 16, 2014    Free full text    Evidence Based Medicine    Clinical Article

13 Tea consumption and leukemia risk: A meta-analysis Tumor Biology, February 12, 2014    Evidence Based Medicine    Clinical Article

14 Adherence to the Mediterranean diet is associated with the severity of non-alcoholic fatty liver disease Clinical Nutrition, August 11, 2014    Clinical Article

15 Coffee consumption and risk of nonaggressive, aggressive and fatal prostate cancer - A dose-response meta-analysis Full Text Annals of Oncology, December 2, 2013    Free full text    Evidence Based Medicine    Clinical Article

16 Sodium zirconium cyclosilicate in hyperkalemia New England Journal of Medicine, November 26, 2014    Evidence Based Medicine    Clinical Article

17 Resveratrol levels and all-cause mortality in older community-dwelling adults JAMA Internal Medicine, May 13, 2014    Evidence Based Medicine    Clinical Article

18 Factor XI antisense oligonucleotide for prevention of venous thrombosis New England Journal of Medicine, December 10, 2014    Evidence Based Medicine    Clinical Article

19 Aspirin in type 2 diabetes, a randomised controlled study: effect of different doses on inflammation, oxidative stress, insulin resistance and endothelial function International Journal of Clinical Practice, December 27, 2013    Clinical Article

20 Liberal versus restrictive blood transfusion strategy: 3-year survival and cause of death results from the FOCUS randomised controlled trial The Lancet, December 19, 2014    Evidence Based Medicine    Clinical Article

Indexed Journals in Internal Medicine: New England Journal of Medicine, The Lancet, Archives of Internal Medicinemore

Make smarter career moves with less time.

Sign up for our free job placement service today and have a dedicated career consultant help locate the right physician job for you!
Click Here for more information.

Get Started Now!

Free-of-charge, no obligation.

Terms and Conditions For M3 Career Consult

By registering with the M3 Career Consult service you authorize M3 USA Corporation to represent you in your job search. The following is a summary of the terms of our service and our mutual obligations to help you find a job:

  • You designate M3 to act as your agent and represent you in your job search;
  • You will not pay us for this service
  • You will advise us of any companies or positions to which you apply or have applied;
  • You will advise us if you believe you are not capable of performing a position for which we submit you, or for which you interview;
  • You will keep all information we provide you about companies or positions strictly confidential;
  • You will promptly provide us with information we request of you;
  • You will make yourself reasonably available for phone, video and in-person conversations and interviews;
  • You will be truthful in all of your communications with us; and
  • You will advise us if anything above changes.
 

The Top Read Articles of 2014 are Now Available

Scouring thousands of peer-reviewed journals and popular press, Our Editors just released the Top Read Articles of the Year. See the Top Read List