Secondary Prevention Lipid Performance Measures

Drozda JP Jr, Ferguson TB Jr, Jneid H, et al.
2015 ACC/AHA Focused Update of Secondary Prevention Lipid Performance Measures: A Report of the American College of Cardiology/American Heart Association Task Force on Performance Measures. J Am Coll Cardiol 2015;Dec 10:[Epub ahead of print].

The following are five key points to remember about the American College of Cardiology (ACC)/American Heart Association (AHA) focused update of secondary prevention lipid performance measures:

  1. Performance measures include some of the most important practice recommendations that may be used for assessment of quality. As such, this published document outlines measures related to the ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk, published in 2013 and pertaining only to secondary prevention.
  2. Data from several studies including large registries such as the National Cardiovascular Data Registry (NCDR) PINNACLE Registry suggest that utilization of statins is not optimal.
  3. Measures were outlined for coronary artery disease (CAD), peripheral artery disease (PAD), percutaneous coronary intervention (PCI), acute myocardial infarction (AMI), and a new measure for atherosclerotic cardiovascular disease (ASCVD).
  4. These performance measures included: for PAD, CAD, and AMI, the number of patients who were offered moderate- to high-intensity statin therapy; for PCI, the number of patients who were offered optimal medical therapy at discharge; and for ASCVD, the number of patients (ages 21-75 years) who were offered moderate- to high-intensity statin therapy. Use of shared decision making was emphasized as a key component of performance measures.
  5. Performance measures should reflect the current guideline’s recommendation for the use of high-intensity statins. Future investigation is required to more accurately evaluate these measures including adherence to performance measures and characteristics of the shared decision process.

Keywords: Atherosclerosis, Cholesterol, Coronary Artery Disease, Decision Making, Dyslipidemias, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Lipids, Myocardial Infarction, National Cardiovascular Data Registries, Percutaneous Coronary Intervention, Peripheral Arterial Disease, PINNACLE Registry, Quality Assurance, Health Care, Risk Factors, Secondary Prevention

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