Abstract 11627: Effectiveness of Statin Therapy in an Urban Metropolitan Patient Population

Abstract

Introduction: Severely elevated serum LDL (>190 mg/dL) is an independent risk factor in the development of ASCVD complications. Despite current guidelines recommending the immediate initiation of high dose statin therapy in high-risk patients, limitations in care continue to exist, especially amongst different genders, races and populations with a higher burden of health disparities. Hypothesis: We assessed the hypothesis of whether or not race and gender affected the timeliness and appropriateness of initiating statin therapy in a patient population that has a higher burden of health disparities. Methods: We performed a single centered, retrospective observational study where 499 patients with an initial LDL level greater than 190 mg/dL were identified. These patients were then stratified according to race and gender and evaluated for intensity and timing of statin therapy for 12 months after their initial lipid profile. Institutional survey data was acquired to quantify health disparities of our patient population in comparison to US census and Chicago Public Health data. Results: All 499 patients were included in the study. The mean LDL was 224.72 mg/dL and the SEM was 1.775 mg/dL. When compared to state and national averages, respectively, patients from our geographic region were found to have a higher percentage of unemployment (11% vs 7% vs 7%), uninsured status (13% vs 9% vs 10%) and inadequate access to transportation (25% vs 11% vs 9%). There was no significant difference between race or gender regarding the timing of statin initiation or degree of statin intensity. Of all patients, 38.2% were not started on any statin while 29.8% were immediately started on statin therapy (p=0.04). Of those patients started on statin therapy, only 11.4% were started on a high intensity statin (p=0.039). Conclusions: In conclusion, we found that, regarding race or gender, there was no significant difference in initiation of statin or strength of statin started. However, the overall percentage of patients that were started on a timely and appropriate dosage was significantly lower, especially in comparison to national averages. This may be due to the high degree of health disparities that are prevalent amongst our patient population.