Preliminary findings from ACC's TRANSFORM: LDL-C Risk quality improvement initiative suggest sharing a focused list of patients for guideline informed actions to reduce atherosclerosis cardiovascular disease (ASCVD) may help to improve LDL control. The early results were released Oct. 8 during ACC Quality Summit Virtual.

The TRANSFORM: LDL-C initiative engaged multiples sites enrolled in ACC and Veradigm's PINNACLE Registry with a high proportion of adult secondary prevention patients with sustained LDL-C > 100 mg/dL from June 2019 to March 2020. Eligible patients also had a prescription history for statins and/or ezetimibe. Key components of the program included sharing a list of 20 – 400 patients with practices; alignment of guideline-directed therapies with payer-related approval algorithms for patients eligible for potential treatment intensification; linking of practices with ACC Quality Ambassadors; access to targeted patient education materials, including a medication initiation plan; and in-person and online clinician education.

Early results for a subset of 220 patients for whom complete data was available show LDL-C values decreased by 23% and that 18% of patients achieved an LDL-C < 70 mg/dL. The majority of patients achieved these results through emphasis on current medical treatment.  Only 7% required intensification on a PCSK9 inhibitor. "These findings may indicate that the QI program proactively managing select patients had an impact on improved LDL control, but additional analysis will be needed with more complete patient data," said Thomas M. Maddox, MD, MSc, FACC, et al.

TRANSFORM LDL-C Risk initiative is developed by the ACC and Regeneron.

Clinical Topics: Dyslipidemia, Prevention, Lipid Metabolism, Nonstatins, Novel Agents, Statins

Keywords: Quality Summit, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Secondary Prevention, Cholesterol, LDL, PCSK9 protein, human, Proprotein Convertase 9, Quality Improvement, Cardiovascular Diseases, Atherosclerosis, Hypolipidemic Agents, Registries, National Cardiovascular Data Registries, PINNACLE Registry

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