Lipid monitoring after initiation of lipid-lowering therapies: Return of performance measures?
Office of the Provost; Cardiology
Purpose of review: The 2015 American College of Cardiology (ACC)/American Heart Association (AHA) Focused Update of Secondary Prevention Lipid Performance Measures removed low-density lipoprotein cholesterol (LDL-C) assessment as a performance measure. This review discusses the evidence supporting the importance of lipid monitoring in the secondary prevention of atherosclerotic cardiovascular disease (ASCVD).
Recent findings: The 2018 AHA/ACC Multisociety cholesterol guideline (as did the 2013 guideline) recommends a lipid panel after initiating lipid-lowering therapy to monitor adherence and medication efficacy. The 2018 guideline also recommends adding nonstatin therapy in very-high-risk ASCVD patients with LDL-C ≥70 mg/dL despite maximally tolerated statin therapy. The removal of LDL-C monitoring as a performance measure is not consistent with the 2018 cholesterol guidelines. Given the importance of monitoring lipid-lowering medication efficacy and adherence and optimally reducing LDL-C in very-high-risk patients with additional evidence-based nonstatin therapy, LDL-C assessment after initiating lipid-lowering therapy should be reinstated as a performance measure for patients with ASCVD.
Publication ( Name of Journal)
Current cardiology reports
Deshotels, M. R.,
Virani, S. S.,
Ballantyne, C. M.
(2021). Lipid monitoring after initiation of lipid-lowering therapies: Return of performance measures?. Current cardiology reports, 23(116).
Available at: https://ecommons.aku.edu/provost_office/368