Journal of clinical lipidology最新文献

{"title":"Impact of Familial Hypercholesterolemia on Coronary Artery Dissection in Patients Undergoing Percutaneous Coronary Intervention (PCI)","authors":"","doi":"10.1016/j.jacl.2024.04.060","DOIUrl":"10.1016/j.jacl.2024.04.060","url":null,"abstract":"<div><h3>Background/Synopsis</h3><p>Cardiac catheterization remains the gold standard for the evaluation of obstructive coronary artery disease in patients presenting with acute coronary syndrome (ACS). Although this procedure is lifesaving, there are several potential life-threatening complications such as coronary artery dissection. The impact of familial hypercholesterolemia (FH) on complication rates in patients presenting with acute coronary syndrome has not been well studied.</p></div><div><h3>Objective/Purpose</h3><p>The purpose of this study was to assess the impact of familial hypercholesterolemia on the development of coronary artery dissection in patients presenting with ACS undergoing percutaneous coronary intervention (PCI).</p></div><div><h3>Methods</h3><p>We performed a retrospective analysis of the NIS database from 2016 to 2018 to identify patients presenting with ACS and PCI using ICD-10-CM/PCS codes. We compared the primary outcome of coronary artery dissection in patients with and without familial hypercholesterolemia. The primary outcome was in-hospital mortality, and secondary outcomes were hypertension, acute kidney injury, cardiogenic shock, obesity, type 2 diabetes mellitus, length of stay, and total hospitalization cost. We performed multivariate logistic regression analysis to identify associations for coronary artery dissection.</p></div><div><h3>Results</h3><p>A total of 58,685 patients presented to the hospital with ACS and underwent PCI. The mean age was 64.85 ± 12.70 years, and most patients were male (69.69%) and Caucasian (75.51%). Patients with familial hypercholesterolemia (FH) had a higher coronary artery dissection rate at 2.27% vs. 1.22%, p = 0.52. There was a difference between patients with and without FH for in-hospital mortality, 0% compared to 4.40%, but not statistically significant (p = 0.15). The length of stay was longer for patients without FH, 4.45 days compared to 3.93 days (p = 0.38). Multiple logistic regression analysis revealed that type 2 diabetes was not a statistically significant predictor of coronary artery dissection, Table 1.</p></div><div><h3>Conclusions</h3><p>The presence of familial hypercholesterolemia was not a statistically significant predictor of coronary artery dissection, but cardiogenic shock was statistically significant. Further pragmatic clinical trials are needed to evaluate familial hypercholesterolemia and association with complications in patients presenting with acute coronary syndrome.</p></div>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141849080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lipoprotein (a) Discovery Project: Initiative to Identify Awareness and Models of Lipoprotein (a) Testing for National Education","authors":"","doi":"10.1016/j.jacl.2024.04.010","DOIUrl":"10.1016/j.jacl.2024.04.010","url":null,"abstract":"<div><h3>Study Funding</h3><p>Novartis is proud to support the American Heart Association's Lp(a) Discovery Project.</p></div><div><h3>Background/Synopsis</h3><p>It is estimated that 1 in 5 Americans have high lipoprotein (a) [Lp(a)] levels. High levels of Lp(a) are an independent, predominantly inherited, and causal risk factor for atherosclerotic cardiovascular disease even in the setting of effective reduction of plasma low-density lipoprotein cholesterol. Race and ethnicity also play a role in Lp(a) regulation. There are currently no standard management approaches for diagnosis or risk assessment, nor any targeted treatments available to lower Lp(a).</p></div><div><h3>Objective/Purpose</h3><p>The American Heart Association (AHA) is implementing a national 3-year initiative called the Lp(a) Discovery Project to understand system-level practice patterns for patients tested for elevated Lp(a). We aim to improve the number of patients tested for Lp(a) by improving processes and workflows across care settings through dissemination of national testing models.</p></div><div><h3>Methods</h3><p>The AHA has engaged 10 champions from diverse health systems with established Lp(a) screening processes and workflows to participate in a Learning Healthcare System model called an Expert Forum. The health systems share best practices and inform on models for Lp(a) testing. Virtual, monthly AHA-led consultant interviews with the health systems are used to document existing provider and health system level Lp(a) testing processes, resources, and barriers. Findings are presented quarterly during virtual Expert Forum meetings, with all participating health systems, to come to consensus on models for national dissemination. Professional education topics identified during these calls are explored to build awareness for the importance of Lp(a) testing. Data on testing rates will be collected through the AHA's Get With The Guidelines (GWTG)-Stroke and GWTG-Coronary Artery Disease modules.</p></div><div><h3>Results</h3><p>From consultations, AHA found that Lp(a) testing awareness for providers and patients varies. There is inconsistent provider knowledge about the importance of Lp(a) testing for a patient's overall cardiovascular risk profile. Providers are sometimes reluctant to order an Lp(a) test because of lack of awareness of next steps for patients with elevated Lp(a), such as intensive management of other risk factors. There is also a need to educate providers on how to talk with their patients about Lp(a) testing and cascade testing for family members for those who have elevated Lp(a).</p></div><div><h3>Conclusions</h3><p>Improving provider and patient awareness of the importance of Lp(a) testing is critical to improving patient care. The Lp(a) Discovery Project is identifying gaps in patient and professional education for Lp(a), barriers to streamlined testing, and implementing strategies to improve national Lp(a) testing rates through professional education a","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141845530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidisciplinary Management of Lipoprotein X-Induced Hyperlipidemia Secondary to Drug-Induced Liver Injury","authors":"","doi":"10.1016/j.jacl.2024.04.028","DOIUrl":"10.1016/j.jacl.2024.04.028","url":null,"abstract":"<div><h3>Background/Synopsis</h3><p>A 72-year-old woman presents with pruritis, jaundice, skin lesions, blurred vision, and facial droop. Blood work reveals a total bilirubin of 21.5 mg/dL (15.4 mg/dL direct, 6.1 mg/dL indirect), AST 388 U/L, ALT 444 U/L, alkaline phosphatase 1,900 U/L, sodium 119 mmol/L, total cholesterol &gt;1350 mg/dL, HDL 7 mg/dL, and triglycerides 306 mg/dL; LDL cannot be calculated. Brain magnetic resonance imaging demonstrates no acute pathology. Viral and autoimmune serologies are negative. Magnetic resonance cholangiopancreatography demonstrates no biliary pathology.</p><p>She reports drinking various herbal tea preparations along with an unknown supplement she purchased on television. A liver biopsy demonstrates bile duct injury and centrilobular cholestasis most consistent with drug-induced liver injury. She is treated with ursodiol and bile acid sequestrants however has ongoing symptoms. Her serum viscosity level is elevated and additional testing detects lipoprotein X. She is treated with three rounds of plasma exchange with normalization of her sodium level, resolution of xanthomas and neurologic symptoms, and marked improvement in her lipid panel.</p></div><div><h3>Objective/Purpose</h3><p>Recognize sequelae of lipoprotein X accumulation including pseudohyponatremia, xanthomas, and hyperviscosity. Discuss multidisciplinary management of lipoprotein X-induced hyperlipidemia.</p></div><div><h3>Methods</h3><p>Clinical case management at a tertiary care lipid program.</p></div><div><h3>Results</h3><p>Lipoprotein-X induced hyperlipidemia is a rare lipoprotein disorder. The most common etiologies are cholestatic liver disease, lecithin:cholesterol acyltransferase (LCAT) deficiency, liver graft-versus-host disease, and lipid infusions. With cholestasis, bile excretion and synthesis are inhibited to prevent bile-induced hepatotoxicity. This results in lack of cholesterol excretion into bile and free cholesterol release into blood, where it merges with phospholipids, albumin, and apolipoproteins C and E, to form lipoprotein X. As lipoprotein X does not contain apolipoprotein B, it does not undergo hepatic clearance and its levels are not affected by lipid-lowering therapies such as statins. Lipoprotein X has a similar density to LDL and can lead to false elevations in LDL on standard lipid panels, therefore lipoprotein electrophoresis can be used to detect lipoprotein X.</p><p>Hyperlipidemia induced by lipoprotein X accumulation can lead to numerous clinical sequelae including xanthomas, pseudohyponatremia, and hyperviscosity syndrome with associated neurologic symptoms. The mainstay of therapy is treatment of the underlying cholestatic disorder, however with refractory symptoms therapeutic plasma exchange can provide rapid lipoprotein clearance.</p></div><div><h3>Conclusions</h3><p>Due to lack of LDL receptor-mediated hepatic clearance, traditional lipid-lowering therapies do not have a role in the management of lipoprotei","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141848923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"†The Role of Structured Inpatient Lipid Protocols in Optimizing Non-Statin Lipid Lowering Therapy: A Review and Single-Center Experience","authors":"","doi":"10.1016/j.jacl.2024.04.046","DOIUrl":"10.1016/j.jacl.2024.04.046","url":null,"abstract":"<div><h3>Background/Synopsis</h3><p>Dyslipidemia is a leading contributor to atherosclerotic cardiovascular disease (ASCVD). There has been a significant improvement in the treatment of dyslipidemia in the past 10 years with the development of new pharmacotherapies. However adherence to guidelines and patients being prescribed appropriate therapy can be improved.</p></div><div><h3>Objective/Purpose</h3><p>The intent of this review is help enhance clinicians understanding of non-statin lipid lowering therapies in accordance with the 2022 American College of Cardiology Expert Consensus Clinical Decision Pathway (ECDP) on the Role of Non-statin Therapies for LDL-Cholesterol Lowering. We also present a single-center experience implementing a systematic inpatient protocol for lipid lowering therapy (LLT) for secondary prevention of ASCVD.</p></div><div><h3>Methods</h3><p>We review the clinical trials for ezetimibe, evolocumab, alirocumab, inclisiran, bempedoic acid and summarize how the medications are implemented for use in the 2022 American College of Cardiology Expert Consensus Clinical Decision Pathway. We conducted a quality improvement retrospective chart analysis study to assess the proportion of patients admitted with non-ST-elevation myocardial infarction or ST-elevation myocardial infarction who underwent percutaneous coronary intervention and were prescribed LLT at discharge from 1/1/2018 to 08/20/2021. A structured inpatient lipid protocol was implemented with the aim of identifying very-high-risk patients, standardizing the initiation and escalation of LLT, and ensuring appropriate monitoring and follow-up. We identify patients admitted with ASCVD event, and obtain baseline LDL-C level. Our pharmacist reviews the patients in the cardiology units and will make recommendations for next step in management. For patients on statin with an LDL-C above 70mg/dL or not on a statin with an LDL-C above 150mg/dL, we maximize the statin and add a PCSK9 inhibitor on discharge. For patients on statin with an LDL-C below 70mg/dL or not on a statin with an LDL-C below 150mg/dL, we maximize the statin and add either ezetimibe or bempedoic acid. The inpatient case manager determines cost and coverage and communicates with the care management specialist to ensure follow up on authorization for medications. For very high risk patients, a referral is placed in the electronic medical record to our advanced lipid management program and the office calls patient to ensure follow up visit is scheduled with repeat lipid panel checked in 4-12 weeks. Cases are reviewed with the lipidologists, care managers, and nurses during a weekly lipid board to discuss treatment plans for the patients scheduled for the upcoming week.</p></div><div><h3>Results</h3><p>Prior to implementation, review of patients from 1/1/2018 to 08/20/2021, our analysis found that 92% of these patients were prescribed statin therapy, but only 66.2% of them had an LDL-C level below 70 mg/dL at their s","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141952465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lomitapide in Pediatric Patients with Homozygous Familial Hypercholesterolemia – Analysis of Secondary and Safety Endpoints from the APH-19 Study","authors":"","doi":"10.1016/j.jacl.2024.04.076","DOIUrl":"10.1016/j.jacl.2024.04.076","url":null,"abstract":"<div><h3>Background/Synopsis</h3><p>Homozygous familial hypercholesterolemia (HoFH) is characterized by mutations in the low-density lipoprotein (LDL) receptor leading to highly elevated levels of LDL-cholesterol (LDL-C). As a result, patients with HoFH develop atherosclerotic cardiovascular disease in childhood and have a low life expectancy of ∼18 years without appropriate treatment. Diagnosis in early childhood is essential to reduce morbidity and mortality. Lomitapide is a selective microsomal triglyceride transfer protein inhibitor approved for adults with HoFH that works independently of the LDL receptor to lower LDL-C. APH-19 (NCT04681170) is the first clinical trial of lomitapide in pediatric patients with HoFH and met its primary endpoint (LDL-C reduction of -53.5% at Week 24; p&lt;0.0001).</p></div><div><h3>Objective/Purpose</h3><p>We report additional parameters from APH-19 relating to the efficacy and safety of lomitapide in pediatric patients.</p></div><div><h3>Methods</h3><p>APH-19 is a phase 3, open-label, single-arm clinical trial in HoFH patients aged 5–17 years (N=43) consisting of a run-in period followed by 24-week efficacy and 80-week safety phases. Patients were stratified by age into three dose escalation groups, where the maximum doses were 20, 40 and 60 mg. Here, additional data at Week 24 of patient-level LDL-C reductions, lipoproteins (apolipoprotein B [ApoB] and lipoprotein A [Lp(a)]) and additional safety endpoints (growth/maturation and fat-soluble vitamin levels) are reported.</p></div><div><h3>Results</h3><p>Lomitapide treatment resulted in up to a 95% reduction of LDL-C from baseline at Week 24 with 53.5% of patients (n=23) having &gt;50% reduction in LDL-C from baseline (Figure). Mean reduction in ApoB was -52.4% at Week 24 (p&lt;0.0001); an ApoB subgroup analysis indicated general consistency across a range of parameters. Mean change from baseline in Lp(a) was -23.6% (p=0.0030) for nmol/L methodology and -11.3% (p=0.2884, Fisher Combined p-value p=0.0070) for mg/dL analysis. Subgroup results will be presented.</p><p>There were no clinically significant mean changes in weight or height from Baseline to Week 24. The mean change in weight-for-age Z-score was -0.371 for patients aged 5–10 years (11–17, N/A). Changes in height-for-age Z-score were -0.064 and -0.060 for patients aged 5–10 and 11–17 years, respectively. Fat-soluble vitamins at Week 24 were within normal range for individuals aged 5–17 years; vitamin E increased in 10.0% of patients aged 5–10 years, considered mild in severity.</p></div><div><h3>Conclusions</h3><p>These data further support the efficacy and safety of lomitapide across various parameters in pediatric patients. The lack of impact on patient maturation endpoints is encouraging; however, further long-term data are required.</p></div>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141845760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"†Real-World Effectiveness and Safety of Evinacumab in Patients with Homozygous Familial Hypercholesterolemia: A Multi-site US Perspective","authors":"Priyesha Bijlani, Michael H Davidson, P. B. Duell, Mary Horan, Mary Malloy, Ron Newfield, P. Pradeep, Prediman Shah, Eveline Stock, Bruce Warden, Matthew K Ito, Michael Wilkinson","doi":"10.1016/j.jacl.2024.04.104","DOIUrl":"https://doi.org/10.1016/j.jacl.2024.04.104","url":null,"abstract":"","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141849942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Food Compass Score is Negatively Related to the Activity of Lipoprotein-Associated Phospholipase A2 (Lp-PLA2) in Healthy Adults.","authors":"E. Fragopoulou, T. Nomikos, Smaragdi Antonopoulou, P. Detopoulou","doi":"10.1016/j.jacl.2024.04.110","DOIUrl":"https://doi.org/10.1016/j.jacl.2024.04.110","url":null,"abstract":"","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141839537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities in access to pharmacotherapies for weight loss and cardiovascular prevention","authors":"","doi":"10.1016/j.jacl.2024.08.001","DOIUrl":"10.1016/j.jacl.2024.08.001","url":null,"abstract":"","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142096117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"†Utility of AI-QCPA: Results of the Decisions for Treating Coronary Disease are Changed in Patients Evaluated with Quantified Plaque Analysis","authors":"Ron Blankstein, Amit Pursnani, C. Rogers, S. Mullen, Nicholas Ng, Steven J. Raible, W. Huey, James Januzzi, Sarah Rinehart","doi":"10.1016/j.jacl.2024.04.121","DOIUrl":"https://doi.org/10.1016/j.jacl.2024.04.121","url":null,"abstract":"","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141851210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rates of Lipid Testing among Patients with Atherosclerotic Cardiovascular Disease within a Large Community-Based Health System","authors":"","doi":"10.1016/j.jacl.2024.04.013","DOIUrl":"10.1016/j.jacl.2024.04.013","url":null,"abstract":"<div><h3>Study Funding</h3><p>This study was sponsored by Amgen, Inc., Thousand Oaks, California.</p></div><div><h3>Background/Synopsis</h3><p>Current American College of Cardiology/American Heart Association (ACC/AHA) guidelines for blood cholesterol management recommend that patients on cholesterol lowering therapy undergo repeat lipid testing every 3 to 12 months to monitor medication adherence and therapeutic effect. Contemporary rates of testing are not well known.</p></div><div><h3>Objective/Purpose</h3><p>pending</p></div><div><h3>Methods</h3><p>We performed a retrospective cross-sectional analysis of patients with atherosclerotic cardiovascular disease (ASCVD) cared for within a large community-based health system within the western US between January 1, 2017, and December 31, 2022. Percentages of annual cohort snapshots were calculated by lipid testing rates using a 12-month look back, stratified by ASCVD risk status (very high-risk [VHR] vs not very high-risk [NVHR] per ACC/AHA guidelines). Additional analyses were performed to assess whether these percentages varied using 1) a 24-month look back (2018-2022) and 2) a 12-month look back plus 3-month look forward. Lipid tests performed outside of the health system were not available for review.</p></div><div><h3>Results</h3><p>A total of 855,258 unique patients with &gt;1 encounter for ASCVD were identified (annual patient counts ranged between 184,860 in 2017 and 430,481 in 2022). The mean age was 71.7 years, 44.8% were female, and 78.6% were White. Using a 12-month look back, only 33.6% and 37.2% of patients underwent some lipid testing in 2017 and 2022, respectively. Consistently higher percentages had some lipid testing among those that were VHR (36.2% in 2017 and 39.8% in 2022) compared to NVHR (29.2% in 2017 and 33.5% in 2022). With a 24-month look back, percentages with some lipid testing rose for all groups over time (47.8% for all patients, 50.9% for VHR patients, and 42.0% for NVHR patients in 2018; 51.5% for all patients, 54.1% for VHR patients, and 46.6% for NVHR patients in 2022). A similar, but less pronounced pattern was observed using a 12-month look back plus 3-month look forward (42.9% for all patients, 44.9% for VHR patients, and 39.3% for NVHR patients in 2017; 47.5% for all patients, 49.3% for VHR patients, and 44.0% for NVHR patients in 2022).</p></div><div><h3>Conclusions</h3><p>Despite guideline recommendations, a large percentage of patients did not undergo any lipid testing in our health system within 12 or 24 months prior to an encounter involving ASCVD. While annual percentages trended toward categories of higher lipid testing rates over time and were consistently higher among VHR patients, further investigation is needed to identify factors associated with different rates of lipid testing.</p></div>","PeriodicalId":15392,"journal":{"name":"Journal of clinical lipidology","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141839846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}