Abstract P192: Improving LDL Documentation and Control in Coronary Artery Disease Patients

Abstract

Background: Obtaining a fasting lipid profile prior to a scheduled clinic visit can facilitate decision making at the time of the visit. However, this places extra burden on patients and can decrease compliance. Purpose: To assess the frequency of lipid measurement in patients asked to have blood draw a week before clinic visit versus on the same day of clinic visit, and assess how this will affect achieving lipid targets. Methods: A University-based cardiology clinic notes were examined. Patients were scheduled for a fasting lipid profile a week prior to the clinic visit in year 1. Poor compliance was noted and prompted a same day as clinic visit measurement of lipids if a patient could not comply with laboratory appointment (fasting or non-fasting) in year 2, with further lipid management conducted by phone. Patients with documented coronary artery disease were included. A total of 200 encounters (100 in each year) were analyzed. Results: Only 64 (64%) of patients in year 1 had lipid measurements, compared to 84 (84%) of patients in year 2. LDL level in year 1 was 116 ± 36 mg/dL compared with 97 ± 32 mg/dL in year 2 (P < 0.01). Only 34% (22/64) of the patients in year 1 achieved LDL of < 100 mg/dL, compared with 56% (47/84) in year 2. No differences were observed in HDL, triglycerides or blood pressures during the concurrent visits. Conclusion: Improving documentation and control of LDL is achievable if lipid levels are done on clinic visit day, with less burden on patients who cannot comply with a separate laboratory appointment. Although there were many non-fasting levels as a result, the triglyceride levels where not significantly different among the two groups, probably reflecting an overall more intensive lipid management in year 2. Therefore, as has been shown by others, a lipid profile in most cases does not necessarily have to be fasting, especially in patients being treated for stricter targets such as our cohort, which may decrease the burden on patients unable to comply with a fasting state or added clinic visits.