Disparities Among Gender and Racial Groups in the Achievement of Optimal Lipid Levels in Patients Following Acute Coronary Syndrome

Abstract

Lead Author's Financial Disclosures Nothing to disclose. Study Funding None. Background/Synopsis Recent literature demonstrates improved outcomes with optimal lipid levels in patients following acute coronary syndrome (ACS). However, historically real-world failures in obtaining optimal lipid levels have been observed. Objective/Purpose Disparities may exist in achieving LDL levels of <70 mg/dL following ACS. Methods A cross-sectional study was employed across the 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 lipid profiles up to 1-year post-discharge. Results We identified 3,386 patients with whom 2,264 (66.8%) were male and 1,122 (33.1%) were female. The majority was white representing 63.5% (2152), followed by 21.2% (718) Black, <4% (119) Asian, <3% (89) Hispanic, <2% (50) East-Indian, and <1% (7) American-Indian. Of this population 1,633 (48.2%) patients had lipid profiles obtained within 1 year follow-up. Post-discharge, percentage of patients with LDL <70 mg/dL: 50.7% (828/1633) total patients, 55.48% (602/1085) male, 41.24% (226/548) female, 53.89% (533/989) White, 41.07% (161/392) Black, 54.01% (33/61) Asian, 44.4% (16/36) Hispanic, 37.93% (11/29) East-Indian, and 80% (4/5) American-Indian. Conclusions About half of patients prescribed guideline directed therapy reached LDL <70 mg/dL at post-discharge. The male group had the highest proportional achievement of LDL <70 mg/dL, versus the female group which had one of the lowest. Among racial groups Black, Hispanic and East-Indian groups had the lowest proportional achievement of LDL <70 mg/dL. Despite a majority of each group being prescribed guideline directed therapy, a minority proportion reach optimal LDL levels. Recognition of these disparities is a step towards addressing the root problems. The etiology of disparities is largely unknown and likely complex requiring a holistic approach to future investigations. Nothing to disclose.