BACKGROUND Statins have an important and well-established role in the prevention of atherosclerotic cardiovascular disease(ASCVD).However,several studies have reported widespread underuse of statins in various practic...BACKGROUND Statins have an important and well-established role in the prevention of atherosclerotic cardiovascular disease(ASCVD).However,several studies have reported widespread underuse of statins in various practice settings and populations.Review of relevant literature reveals opportunities for improvement in the implementation of guideline-directed statin therapy(GDST).AIM To examine the impact of cardiologist intervention on the use of GDST in the ambulatory setting.METHODS Patients with at least one encounter at the adult Internal Medicine Clinic(IMC)and/or Cardiology Clinic(CC),who had an available serum cholesterol test performed,were evaluated.The 2 comparison groups were defined as:(1)Patients only seen by IMC;and(2)Patients seen by both IMC and CC.Patients were excluded if variables needed for calculation of ASCVD risk scores were lacking,and if demographic information lacked guideline-directed treatment recommendations.Data were analyzed using student t-tests or χ^2,as appropriate.Analysis of Variance was used to compare rates of adherence to GDST.RESULTS A total of 268 patients met the inclusion criteria for this study;211 in the IMC group and 57 in the IMC-CC group.Overall,56%of patients were female,mean age 56 years(±10.65,SD),22%Black or African American,56%Hispanic/Latino,14%had clinical ASCVD,13%current smokers,66%diabetic and 63%hypertensive.Statin use was observed in 55%(n=147/268)of the entire patient cohort.In the IMC-CC group,73.6%(n=42/57)of patients were prescribed statin therapy compared to 50.7%(n=107/211)of patients in the IMC group(P=0.002).In terms of appropriate statin use based on guidelines,there was no statistical difference between groups[IMC-CC group 61.4%(n=35/57)vs IMC group,55.5%(n=117/211),P=0.421].Patients in the IMC-CC group were older,had more cardiac risk factors and had higher proportions of non-white patients compared to the IMC group(P<0.02,all).CONCLUSION Although overall use of GDST was suboptimal,there was no statistical difference in appropriate statin use based on guidelines between groups managed by general internists alone or co-managed with a cardiologist.These findings highlight the need to design and implement strategies to improve adherence rates to GDST across all specialties.展开更多
Prof.YIN Hui-jin,Ph.D., male, was born on March 26, 1971 in Ningxia.He graduated from Ningxia Medical College in 1994 with a 5-year course and got a bachelor degree,and then further studied in Heilongjiang University ...Prof.YIN Hui-jin,Ph.D., male, was born on March 26, 1971 in Ningxia.He graduated from Ningxia Medical College in 1994 with a 5-year course and got a bachelor degree,and then further studied in Heilongjiang University of Traditional Chinese Medicinefrom 1994 to 2000 for master and Ph.D. degrees. And then he worked in postdoctoral mobile working station of Open Laboratory of Heredity and Molecule Development Biology of China Academy of Science from 2000 to 2002.展开更多
Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treat...Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.展开更多
Prof. DAI Ruihong was born in Wenzhou, Zhejiang province in 1930. He attended the medical school of St. John University, Shanghai, in 1949, and obtained the medical degree at Shanghai＇s Second Medical College in 1955...Prof. DAI Ruihong was born in Wenzhou, Zhejiang province in 1930. He attended the medical school of St. John University, Shanghai, in 1949, and obtained the medical degree at Shanghai＇s Second Medical College in 1955. Since then he has been devoted to ,in Huashan Hospital, clinical, teaching as well as research duties in the field of cardiovascular disease, particularly in coronary heart disease （CHD） and myocardial infarction. Prof. DAI has devoted to the integrative traditional Chinese and Western medicinal treatment on CHD and the clinical pharmacology of cardiovascular disease for over 50 years.展开更多
文摘BACKGROUND Statins have an important and well-established role in the prevention of atherosclerotic cardiovascular disease(ASCVD).However,several studies have reported widespread underuse of statins in various practice settings and populations.Review of relevant literature reveals opportunities for improvement in the implementation of guideline-directed statin therapy(GDST).AIM To examine the impact of cardiologist intervention on the use of GDST in the ambulatory setting.METHODS Patients with at least one encounter at the adult Internal Medicine Clinic(IMC)and/or Cardiology Clinic(CC),who had an available serum cholesterol test performed,were evaluated.The 2 comparison groups were defined as:(1)Patients only seen by IMC;and(2)Patients seen by both IMC and CC.Patients were excluded if variables needed for calculation of ASCVD risk scores were lacking,and if demographic information lacked guideline-directed treatment recommendations.Data were analyzed using student t-tests or χ^2,as appropriate.Analysis of Variance was used to compare rates of adherence to GDST.RESULTS A total of 268 patients met the inclusion criteria for this study;211 in the IMC group and 57 in the IMC-CC group.Overall,56%of patients were female,mean age 56 years(±10.65,SD),22%Black or African American,56%Hispanic/Latino,14%had clinical ASCVD,13%current smokers,66%diabetic and 63%hypertensive.Statin use was observed in 55%(n=147/268)of the entire patient cohort.In the IMC-CC group,73.6%(n=42/57)of patients were prescribed statin therapy compared to 50.7%(n=107/211)of patients in the IMC group(P=0.002).In terms of appropriate statin use based on guidelines,there was no statistical difference between groups[IMC-CC group 61.4%(n=35/57)vs IMC group,55.5%(n=117/211),P=0.421].Patients in the IMC-CC group were older,had more cardiac risk factors and had higher proportions of non-white patients compared to the IMC group(P<0.02,all).CONCLUSION Although overall use of GDST was suboptimal,there was no statistical difference in appropriate statin use based on guidelines between groups managed by general internists alone or co-managed with a cardiologist.These findings highlight the need to design and implement strategies to improve adherence rates to GDST across all specialties.
文摘Prof.YIN Hui-jin,Ph.D., male, was born on March 26, 1971 in Ningxia.He graduated from Ningxia Medical College in 1994 with a 5-year course and got a bachelor degree,and then further studied in Heilongjiang University of Traditional Chinese Medicinefrom 1994 to 2000 for master and Ph.D. degrees. And then he worked in postdoctoral mobile working station of Open Laboratory of Heredity and Molecule Development Biology of China Academy of Science from 2000 to 2002.
文摘Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.
文摘Prof. DAI Ruihong was born in Wenzhou, Zhejiang province in 1930. He attended the medical school of St. John University, Shanghai, in 1949, and obtained the medical degree at Shanghai＇s Second Medical College in 1955. Since then he has been devoted to ,in Huashan Hospital, clinical, teaching as well as research duties in the field of cardiovascular disease, particularly in coronary heart disease （CHD） and myocardial infarction. Prof. DAI has devoted to the integrative traditional Chinese and Western medicinal treatment on CHD and the clinical pharmacology of cardiovascular disease for over 50 years.
