Clinical Edge

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Improving Adherence with ASCVD Interventions

Clin Cardiol; ePub 2018 Apr 17; Fentanes, et al

Advanced practice providers (APPs) within a preventive cardiology clinic effectively risk stratify and aggressively manage atherosclerotic cardiovascular disease (ASCVD) risk factors, resulting in a reduction in post-intervention, a recent study found. The retrospective study examined data from 595 patients enrolled in a preventive cardiology clinic (PCC) utilizing APPs compared with a propensity-matched cohort (PMC) of 595 patients enrolled in primary care clinical. PCC patents were risk stratified using Framingham risk scoring (FRS) and coronary artery calcium scoring (CACS) and treated based on published guideline-based algorithms. Researchers found:

  • CACS was more commonly obtained in PCC patients resulting in reclassification of 30.6% patients to a higher risk category, including statin therapy in 26.6% of low FRS PCC patients with CACS ≥75th MESA percentile.
  • Post-intervention mean LDL, non-HDL, and triglycerides were lower in the PCC group.
  • Compliance with appropriate lipid treatment was higher in intermediate to high FRS patients in the PCC group.
  • Aggressive LDL and non-HDL treatment goals <70 mg/dL and <130 mg/dL, respectively, were more commonly achieved in high FRS PCC patients.

Citation:

Fentanes E, Vande Hei AG, Holuby S, et al. Treatment in a preventive cardiology clinic utilizing advanced practice providers (APPs) effectively closes atherosclerotic cardiovascular disease (ASCVD) risk management gaps amongst a primary prevention population compared with a propensity-match primary care cohort: A team based care model and its impact on lipid and blood pressure management. [Published online ahead of print April 17, 2018]. Clin Cardiol. doi:10.1002/clc.22963.

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