Abstract 9681: Guideline Directed Lipid Therapy Prescribing Patterns Contrasted by Achievement in Optimal Lipid Levels in Patients Following Acute Coronary Syndrome

Abstract

Introduction: Initiation of guideline directed lipid therapy (GDLT) for patients following acute coronary syndrome (ACS) is a well-established secondary prevention. Despite this, variable prescriber adherence to GDLT has been observed and it is not well understood how this impacts achievement of optimal LDL across gender and racial groups. Hypothesis: Gender and racial disparities in GDLT and subsequent achievement of LDL <70 mg/dL exist. Methods: A cross-sectional study was employed across University of Pennsylvania Health System from 2018 to 2019. Electronic medical records were queried for all admitted patients diagnosed with ACS. Data was collected for age, gender, race, and prescribed lipid medication at both discharge and up to 1-year post-discharge. Results: We identified 3386 patients of which 66.8% were male and 33.1% were female. The majority was white (63.5%), followed by 21.2% Black, <4% Asian, <3%, <2% East Indian, and <1% American Indian. Discharge compared to post-discharge percentages of prescribed GDLT are as follows: 78.0% to 62.9% all patients; 75.2% to 60.8% White, 82.6% to 72.4% Black, 78.1% to 49.1% Asian, 85.8% to 64.7% Hispanic, 77.1% to 58.3% East Indian, 85.7% to 57.1% American Indian. At post-discharge, patients with LDL <70 mg/dL are as follows: 50.7% all patients, 55.5% male, 41.2% female, 53.9% White, 41.1% Black, 54.0% Asian, 44.4% Hispanic, 37.9% East Indian, and 80% American Indian. Non-statin therapy was only prescribed to 13.3% of all patients. Conclusions: Disparities were observed among gender and racial groups in both prescribed GDLT and sustained LDL levels < 70 mg/dL. The first step in overcoming disparities is through recognition. An improved holistic understanding of the existing disparities through further investigation will allow for targeted improvements in care and outcomes.