Retrospective Cohort Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Aug 26, 2020; 12(8): 419-426
Published online Aug 26, 2020. doi: 10.4330/wjc.v12.i8.419
Impact of cardiologist intervention on guideline-directed use of statin therapy
Manouchkathe Cassagnol, Ofek Hai, Shaqeel A Sherali, Kyla D’Angelo, David Bass, Roman Zeltser, Amgad N Makaryus
Manouchkathe Cassagnol, Ofek Hai, Kyla D’Angelo, Roman Zeltser, Amgad N Makaryus, Department of Cardiology, NuHealth/Nassau University Medical Center, East Meadow, NY 11554, United States
Manouchkathe Cassagnol, Department of Clinical Health Professions, College of Pharmacy and Health Sciences, St. John’s University, Queens, NY 11430, United States
Shaqeel A Sherali, Roman Zeltser, Amgad N Makaryus, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY 11549, United States
David Bass, St. Lawrence Health System, Potsdam, NY 13676, United States
Author contributions: Cassagnol M, Hai O, Zeltser R, Makaryus AN designed the research and wrote the paper; Sherali SA, D’Angelo K and Bass D performed the research, Zeltser R and Makaryus AN critically revised the manuscript for important intellectual content.
Institutional review board statement: NuHealth/Nassau University Medical Center Institutional Review Board; Approval IRB# 17-139.
Informed consent statement: This retrospective study with anonymized data does not require informed consent due to no identifiable data as approved by our institutional review board.
Conflict-of-interest statement: No conflicts of interest exist for any of the authors relating to this study.
Data sharing statement: No additional data.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Amgad N Makaryus, MD, Professor, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell; Chairman, Department of Cardiology, Nassau University Medical Center, 2201 Hempstead Turnpike, East Meadow, NY 11554, United States. amakaryu@numc.edu
Received: February 28, 2020
Peer-review started: February 28, 2020
First decision: April 25, 2020
Revised: May 13, 2020
Accepted: August 1, 2020
Article in press: August 1, 2020
Published online: August 26, 2020
ARTICLE HIGHLIGHTS
Research 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.

Research motivation

Review of relevant literature reveals opportunities for improvement in the implementation of guideline-directed statin therapy (GDST).

Research objectives

In this study, we aimed to examine the impact of cardiologist intervention on the use of statin therapy in the ambulatory setting.

Research methods

We conducted a retrospective chart review of patients who had at least one encounter at the adult Internal Medicine Clinic (IMC) and/or Cardiology Clinic (CC) and who had an available serum cholesterol test performed. The 2 comparison groups were defined as: (1) Patients only seen by IMC; and (2) Patients seen by both IMC and CC. Baseline characteristics of subgroups were compared.

Research result

A total of 268 patients met the inclusion criteria for this study. Approximately, 14% had clinical ASCVD, 13% were current smokers, 66% were diabetic, and 63% were hypertensive. Statin use was observed in 55% of the entire cohort, with moderate- intensity statins being the most commonly prescribed. Overall, in the IMC-CC group, 73.6% of patients were prescribed statin therapy compared to 50.7% of patients in the IMC group. There was no statistical difference in the use of GDST between groups.

Research conclusions

Our study compared the use of GDST in patients managed by general internists and those co-managed by a cardiologist. Overall, statin use in this population is comparable to what other studies have shown and highlights the need to design and implement strategies to improve prescriber adherence to GDST.