Adoption of the 2013 American College of Cardiology/American Heart Association Cholesterol Management Guideline in Cardiology Practices Nationwide

作者：Yashashwi Pokharel, Fengming Tang, Philip G. Jones, Vijay Nambi, Vera Bittner, Ravi S. Hira, Khurram Nasir, Paul S. Chan, Thomas M. Maddox, William J. Oetgen, Paul A. Heidenreich, William B. Borden, John A. Spertus, Laura A. Petersen, Christie M. Ballantyne, Salim S. Virani · 发表于：JAMA Cardiology · 年份：2017 · DOI：10.1001/jamacardio.2016.5922 · 被引用次数：109 · 研究领域：Lipoproteins and Cardiovascular Health、Health Promotion and Cardiovascular Prevention、Cardiac Health and Mental Health

Importance: The 2013 American College of Cardiology/American Heart Association (ACC/AHA) Cholesterol Management Guideline recommends moderate-intensity to high-intensity statin therapy in eligible patients. Objective: To examine adoption of the 2013 ACC/AHA guideline in US cardiology practices. Design, Setting, and Participants: Among 161 cardiology practices, trends in the use of moderate-intensity to high-intensity statin and nonstatin lipid-lowering therapy (LLT) were analyzed before (September 1, 2012, to November 1, 2013) and after (February 1, 2014, to April 1, 2015) publication of the 2013 ACC/AHA guideline among 4 mutually exclusive risk groups within the ACC Practice Innovation and Clinical Excellence Registry. Interrupted time series analysis was used to evaluate for differences in trend in use of moderate-intensity to high-intensity statin and nonstatin LLT use in hierarchical logistic regression models. Participants were a population-based sample of 1 105 356 preguideline patients (2 431 192 patient encounters) and 1 116 472 postguideline patients (2 377 219 patient encounters). Approximately 97% of patients had atherosclerotic cardiovascular disease (ASCVD). Exposures: Moderate-intensity to high-intensity statin and nonstatin LLT use before and after publication of the 2013 ACC/AHA guideline. Main Outcomes and Measures: Time trend in the use of moderate-intensity to high-intensity statin and nonstatin LLT. Results: In the study cohort, the mean (SD) age was 69.6 ...