Cardiology clinic visit increases likelihood of evidence-based cholesterol prescribing in severe hypercholesterolemia.

Abstract:

BACKGROUND:Patients with phenotypic severe hypercholesterolemia (SH), low-density lipoprotein-cholesterol (LDL-c) ≥ 190 mg/dl, atherosclerotic cardiovascular disease (ASCVD) or adults 40-75 years with diabetes with risk factors or 10-year ASCVD risk ≥20% benefit from maximally tolerated statin therapy. Rural patients have decreased access to specialty care, potentially limiting appropriate treatment. HYPOTHESIS:Prior visit with cardiology will improve treatment of severe hypercholesterolemia. METHODS:We used an electronic medical record-based SH registry defined as ever having an LDL-c ≥ 190 mg/dl since January 1, 2000 (n = 18 072). We excluded 3205 (17.7%) patients not alive or age 20-75 years. Patients defined as not seen by cardiology if they had no visit within the past 3 years (2017-2019). RESULTS:We included 14 867 patients (82.3%; mean age 59.7 ± 10.3 years; 58.7% female). Most patients were not seen by cardiology (n = 13 072; 72.3%). After adjusting for age, sex, CVD, hypertension, diabetes and obesity, patients seen by cardiology were more likely to have any lipid-lowering medication (OR = 1.46, 95% CI: 1.29-1.65), high-intensity statin (OR = 1.81, 95% CI: 1.61-2.03), or proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitor (OR = 5.96, 95% CI: 3.34-10.65) compared to those not seen by cardiology. Mean recent LDL-c was lower in patients seen by cardiology (126.8 ± 51.6 mg/dl vs. 152.4 ± 50.2 mg/dl, respectively; p < .001). CONCLUSION:In our predominantly rural population, a visit with cardiology improved the likelihood to be prescribed any statin, a high-intensity statin, or PCSK9 inhibitor. This more appropriately addressed their high life-time risk of ASCVD. Access to specialty care could improve SH patient's outcomes.

journal_name

Clin Cardiol

journal_title

Clinical cardiology

authors

Groth NA,Stone NJ,Benziger CP

doi

10.1002/clc.23521

subject

Has Abstract

pub_date

2020-12-23 00:00:00

eissn

0160-9289

issn

1932-8737

pub_type

杂志文章
  • Acute myocardial infarction in patients with normal coronary arteries after acute ethanol intoxication.

    abstract::Three cases are presented where acute myocardial infarction occurred in young individuals after an episode of heavy alcohol intake. Subsequent coronary arteriograms demonstrated normal coronary arteries. Several mechanisms by which acute ethanol intoxication might precipitate myocardial infarction are discussed. To ou...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960050707

    authors: Moreyra AE,Kostis JB,Passannante AJ,Kuo PT

    更新日期:1982-07-01 00:00:00

  • Combination of ramipril and hydrochlorothiazide in the treatment of mild to moderate hypertension--Part 2: An open long-term study of efficacy and safety.

    abstract::In an open, multicenter extension of a short-term study, 159 patients with mild to moderate hypertension were treated with either ramipril monotherapy or a combination of ramipril and hydrochlorothiazide for up to 1 year. Patients started with either 5 mg ramipril once daily (responders in the short-term study) or a c...

    journal_title:Clinical cardiology

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1002/clc.4960160111

    authors: Heidbreder D,Froer KL,Bauer B,Cairns V,Breitstadt A,Bender N

    更新日期:1993-01-01 00:00:00

  • Association of conventional and exertional coronary heart disease risk factors in 5,000 apparently healthy men.

    abstract:BACKGROUND AND HYPOTHESIS:The aim of this study was to define the prevalence of previously undetected coronary heart disease among asymptomatic males, aged 30-65 years, by means of resting and exercise electrocardiography in conjunction with an analysis of conventional and exertional coronary risk factors. METHODS:Bet...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960190405

    authors: Davies B,Ashton WD,Rowlands DJ,eL-Sayed M,Wallace PC,Duckett K,Coley J,Daggett AM

    更新日期:1996-04-01 00:00:00

  • Percutaneous Closure of Paravalvular Regurgitation After Transcatheter Aortic Valve Implantation: A Systematic Review.

    abstract::Paravalvular regurgitation (PVR) remains one of the drawbacks of transcatheter aortic valve implantation (TAVI). Details of percutaneous closure (PCC) of PVR after TAVI remain obscure. We aimed to explore the patient characteristics, procedural details, closure devices used, and outcomes of PCC after TAVI. A systemati...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,评审

    doi:10.1002/clc.22569

    authors: Ando T,Takagi H,ALICE (All-Literature Investigation of Cardiovascular Evidence) Group.

    更新日期:2016-10-01 00:00:00

  • Current role of contrast echocardiography in the diagnosis of cardiovascular diseases.

    abstract::The use of contrast echocardiography (CE) in cardiovascular medicine has grown significantly over the last 15 years. Depending on the site of injection, contrast enhancement of the right- or left-sided cardiac chambers or myocardium now can be achieved. Contrast echocardiography can improve the evaluation of patients ...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960201308

    authors: Pérez JE

    更新日期:1997-10-01 00:00:00

  • Elevated serum cardiac troponin in non-acute coronary syndrome.

    abstract::Cardiac troponins (CTn) are the most sensitive and specific biochemical markers of myocardial injury and risk stratification. The assay for troponin T (cTnI) is standardized, and results obtained from different institutions are comparable. This is not the case with troponin I (cTnT), and clinicians should be aware tha...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,评审

    doi:10.1002/clc.20445

    authors: Agzew Y

    更新日期:2009-01-01 00:00:00

  • Nicardipine, a new calcium channel blocker: role for vascular selectivity.

    abstract::Calcium channel blockers are important drugs for the treatment of chronic stable angina. However, negative inotropic and dromotropic effects may limit their usefulness in patients with atrioventricular conduction abnormalities or left ventricular dysfunction. A new generation of calcium channel blockers will soon be a...

    journal_title:Clinical cardiology

    pub_type: 临床试验,杂志文章,评审

    doi:10.1002/clc.4960120503

    authors: Pepine C

    更新日期:1989-05-01 00:00:00

  • Predictors of Medical Management in Patients Undergoing Elective Cardiac Catheterization for Chronic Ischemic Heart Disease.

    abstract:BACKGROUND:Compared with medical therapy, percutaneous coronary intervention (PCI) does not reduce mortality or myocardial infarction in patients with stable angina. Therefore, PCI should be guided by refractory anginal symptoms and not just lesion characteristics. HYPOTHESIS:We hypothesized that angiographic lesion c...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.22510

    authors: Atreya AR,Sivalingam SK,Arora S,Kashef MA,Fitzgerald J,Visintainer P,Lotfi A,Rothberg MB

    更新日期:2016-04-01 00:00:00

  • Platelet reactivity in response to loading dose of atorvastatin or rosuvastatin in patients with stable coronary disease before percutaneous coronary intervention: The STATIPLAT randomized study.

    abstract:BACKGROUND:The acute effects of statin loading dose (LD) on platelet reactivity in patients with chronic stable angina (CSA) are not completely clear. HYPOTHESIS:We hypothesized that LDs of atorvastatin and rosuvastatin have different pharmacodynamic acute effects on platelet aggregability in CSA patients with baselin...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1002/clc.22709

    authors: Godino C,Pavon AG,Mangieri A,Salerno A,Cera M,Monello A,Chieffo A,Magni V,Cappelletti A,Margonato A,Colombo A

    更新日期:2017-08-01 00:00:00

  • Elimination of unstable angina by diltiazem under temporary pacing.

    abstract::We describe two patients in whom spontaneous angina following acute myocardial infarction (postinfarction angina caused by coronary artery spasm) and worsening angina were successfully eliminated after clinical dosage of oral diltiazem, while marked sinus node suppression developed and temporary pacing was performed. ...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960071110

    authors: Ishikawa T,Imamura T,Koiwaya Y,Tanaka K

    更新日期:1984-11-01 00:00:00

  • Significance of aortic valve calcification in patients with low-gradient low-flow aortic stenosis.

    abstract:BACKGROUND:Assessment of patients with aortic stenosis (AS) and impaired left ventricular function remains challenging. Aortic valve calcium (AVC) scoring with computed tomography (CT) and fluoroscopy has been proposed as means of diagnosing and predicting outcomes in patients with severe AS. HYPOTHESIS:Severity of ao...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.22212

    authors: Aksoy O,Cam A,Agarwal S,Ige M,Yousefzai R,Singh D,Griffin BP,Schoenhagen P,Kapadia SR,Tuzcu ME

    更新日期:2014-01-01 00:00:00

  • Comparison of usual care and the HEART score for effectively and safely discharging patients with low-risk chest pain in the emergency department: would the score always help?

    abstract:BACKGROUND:Triage decisions for chest pain patients receiving usual care are based on a dynamic and comprehensive strategy performed in the physician's mind. It remains controversial whether simple, structured risk tools can surpass real, complex judgments. HYPOTHESIS:The potentially used History, Electrocardiogram, A...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.23325

    authors: Wang G,Zheng W,Wu S,Ma J,Zhang H,Zheng J,Wang J,Xu F,Chen Y

    更新日期:2020-04-01 00:00:00

  • Release of adenosine and lactate from human hearts during atrial pacing in patients with ischemic heart disease.

    abstract::Thirty-eight patients treated by atrial pacing were divided into three groups (Group I, patients with neither coronary stenosis nor anginal pain during pacing; Group II, patients with no coronary stenosis but having anginal pain during pacing; Group III, patients with coronary stenosis). The concentrations of adenosin...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960120203

    authors: Haneda T,Ichihara K,Abiko Y,Onodera S

    更新日期:1989-02-01 00:00:00

  • Left ventricular mass assessed by three-dimensional echocardiography using rotational acquisition.

    abstract:BACKGROUND:The reproducibility of left ventricular (LV) mass measurement by two-dimensional (2-D) echocardiography is inadequate for individual assessments. HYPOTHESIS:This study was undertaken to evaluate the potential of LV mass determination with a new three-dimensional (3-D) echocardiographic method compared with ...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960201111

    authors: Rodevand O,Bjornerheim R,Kolbjornsen O,Ihlen H,Kjekshus J

    更新日期:1997-11-01 00:00:00

  • Black scorpion envenomation: two cases and review of the literature.

    abstract::Scorpion envenomation is quite common in India, southeast Asia, the U.S. southwest, and Israel (in the Negev and around Jerusalem). Yellow scorpion is considered the most dangerous scorpion that causes cardiac toxicity. Two patients are described, who lived in a nonendemic area of yellow scorpions and were envenomated...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960150514

    authors: Blum A,Lubezki A,Sclarovsky S

    更新日期:1992-05-01 00:00:00

  • Refining the treatment of women with unstable angina--a randomized, double-blind, comparative safety and efficacy evaluation of Integrelin versus aspirin in the management of unstable angina.

    abstract:BACKGROUND:Although women typically develop coronary artery disease several years after men, once they have symptomatic disease their thromboembolic complications are worse than in men. The mechanism mediating this gender difference in outcome after thromboembolic events is unknown. We previously studied platelet funct...

    journal_title:Clinical cardiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1002/clc.4960191106

    authors: Goldschmidt-Clermont PJ,Schulman SP,Bray PF,Chandra NC,Grigoryev D,Dise KR,Sagar M,Fox RJ,Coleman LD,Richardson C,Dorsey FC,du Mee C,Kitt MM,Ouyang P,Baughman KL,Gerstenblith G

    更新日期:1996-11-01 00:00:00

  • Thallium-201 single-photon emission computed tomography: quantitative assessment of left ventricular perfusion and structural change in patients with chronic aortic regurgitation.

    abstract:BACKGROUND:Previously, perfusion defect in the left ventricle was detected by thallium-201 (201T1) single-photon emission computed tomography (SPECT) in aortic regurgitation (AR). The significance of 201T1 SPECT, however, has not been clarified. Limited information is available regarding the relationship between functi...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960281206

    authors: Yasuda H,Taniguchi K,Takahashi T,Sawa Y,Matuda H

    更新日期:2005-12-01 00:00:00

  • Outcomes associated with preoperative use of extracorporeal membrane oxygenation in children undergoing heart operation for congenital heart disease: a multi-institutional analysis.

    abstract:BACKGROUND:There are very sparse data on patient outcomes related to the use of extracorporeal membrane oxygenation (ECMO) prior to heart operation in children with congenital heart disease. This study was designed to evaluate this association using the Pediatric Health Information System (PHIS) database. HYPOTHESIS:W...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,多中心研究

    doi:10.1002/clc.22358

    authors: Gupta P,Robertson MJ,Beam BW,Rettiganti M

    更新日期:2015-02-01 00:00:00

  • The echocardiographic association of mitral valve prolapse and mitral anulus calcification.

    abstract::Mitral anulus calcification (MAC) and mitral valve prolapse (MVP) are frequently diagnosed conditions. We studied two patients with mild or moderate mitral regurgitation who demonstrated both MAC and MVP on angiography and echocardiography. M-mode echocardiography is probably the definitive test for confirming the pre...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960020309

    authors: McLean J,Felner JM,Whipple R,Morris D,Schlant RC

    更新日期:1979-06-01 00:00:00

  • The role of prolonged thrombolytic infusions and transesophageal echocardiography in thrombosed prosthetic heart valves: case report and review of the literature.

    abstract::Thrombolytic therapy for prosthetic heart valve thrombosis has recently been receiving increased attention and is now frequently used an alternative to high-risk surgery. A case is presented describing a novel thrombolytic therapy regimen with emphasis on the role of transesophageal echocardiography in diagnosis and m...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,评审

    doi:10.1002/clc.4960181117

    authors: Puleo JA,Fontanet HL,Schocken DD

    更新日期:1995-11-01 00:00:00

  • Management of coronary artery disease in patients undergoing elective abdominal aortic aneurysm open repair.

    abstract:BACKGROUND:The efficacy of prophylactic coronary revascularization with percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) surgery in patients with abdominal aortic aneurysm (AAA) scheduled for open repair surgery remains controversial. HYPOTHESIS:Concomitant coronary artery disease (CAD) ...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.20335

    authors: Hosokawa Y,Takano H,Aoki A,Inami T,Ogano M,Kobayashi N,Tanabe J,Yokoyama H,Kato T,Takagi H,Umemoto T,Takayama M,Mizuno K

    更新日期:2008-12-01 00:00:00

  • Angioscopic visualization of blood vessel interior in animals and humans.

    abstract::The purpose of this study is to describe the use of angioscopes in flowing bloodstreams of animals and humans, to demonstrate the ability to precisely deliver laser energy to an intravascular target using visual guidance and to determine the information content and spatial content of angioscopy. Angioscopy was perform...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960080202

    authors: Litvack F,Grundfest WS,Lee ME,Carroll RM,Foran R,Chaux A,Berci G,Rose HB,Matloff JM,Forrester JS

    更新日期:1985-02-01 00:00:00

  • Prolonged low-dose thrombolytic therapy: a novel adjunctive strategy in the management of an infected right atrial thrombus.

    abstract::An 81-year-old man presented with a large, infected right atrial thrombus that was refractory to anticoagulants and several courses of antibiotics. The risk of surgical removal of the thrombus, which was associated with a pacemaker electrode, was considered prohibitive. The patient was treated for 7 days with low-dose...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4950250709

    authors: Chuang S,Mehta RH,Fay WP

    更新日期:2002-07-01 00:00:00

  • Lack of association between electronic health record systems and improvement in use of evidence-based heart failure therapies in outpatient cardiology practices.

    abstract:BACKGROUND:Electronic health record systems (EHR) are expected to facilitate higher quality patient care; however, studies evaluating EHR effectiveness in improving care have yielded mixed results. HYPOTHESIS:Implementation of a performance improvement system in outpatient practices with EHR may better demonstrate the...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.21971

    authors: Walsh MN,Albert NM,Curtis AB,Gheorghiade M,Heywood JT,Liu Y,Mehra MR,O'Connor CM,Reynolds D,Yancy CW,Fonarow GC

    更新日期:2012-03-01 00:00:00

  • Hypoadiponectinemia is associated with prehypertension in obese individuals of multiethnic origin.

    abstract:BACKGROUND:Considering that prehypertension is associated with an increase in cardiovascular risk, hypoadiponectinemia seems to be a predictor of hypertension. HYPOTHESIS:This study investigated whether adiponectin plasma levels are affected in Brazilian obese prehypertensives compared with those in normotensives and ...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.20657

    authors: Celoria BM,Genelhu VA,Pimentel Duarte SF,Delfraro PA,Francischetti EA

    更新日期:2010-06-01 00:00:00

  • Refractory swallowing-induced paroxysmal supraventricular tachycardia.

    abstract::A 51-year-old female with a two-year history of palpitations associated with swallowing was evaluated by intracardiac electrophysiologic studies. Intracardiac recordings documented the presence of an ectopic left atrial focus induced by swallowing with no evidence of accessory pathway conduction. Gastrointestinal eval...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960110117

    authors: Ransbottom JC,Mirro MJ

    更新日期:1988-01-01 00:00:00

  • Hypertrophic cardiomyopathy: two-dimensional echocardiographic score versus clinical and electrocardiographic findings.

    abstract::The severity and site of hypertrophy is important in determining the clinical picture and the natural history of hypertrophic cardiomyopathy (HCM). We evaluated left ventricular hypertrophy by means of two-dimensional echocardiographic score and score index, and correlated these findings with symptoms, electrovector-c...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960120809

    authors: Melacini P,Fasoli G,Canciani B,Buja G,Mammola C,Volta SD

    更新日期:1989-08-01 00:00:00

  • Impact of thallium-201 imaging on clinical assessment and management of patients with chest pain.

    abstract::The histories, rest, and exercise ECG results of 60 patients without myocardial infarction complaining of chest pain were submitted to 6 physicians (3 cardiologists and 3 noncardiologists) who were unaware of the angiographic findings. The physicians were requested to estimate the probability of coronary artery diseas...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960071207

    authors: Schmoliner R,Dudczak R,Kronik G,Mösslacher H,Zangeneh M,Pollak C,Schurz B,Schoberwalter A

    更新日期:1984-12-01 00:00:00

  • A casual spontaneous mutation as possible cause of the familial form of arrhythmogenic right ventricular cardiomyopathy (arrhythmogenic right ventricular dysplasia).

    abstract::In a family affected by arrhythmogenic right ventricular cardiomyopathy (ARVC) the familial occurrence was investigated. All 14 members of two generations were investigated carefully, and only 2 (father and one son) members were affected. Both subjects had a massive form of the disease with relevant ventricular arrhyt...

    journal_title:Clinical cardiology

    pub_type: 杂志文章

    doi:10.1002/clc.4960150314

    authors: Canciani B,Nava A,Toso V,Martini B,Thiene G

    更新日期:1992-03-01 00:00:00

  • Recent advances in dobutamine stress echocardiography.

    abstract::Dobutamine stress echocardiography (DSE) is a reliable cardiac risk stratifier that has widespread applicability because of its clinical accuracy and cost effectiveness. Dobutamine has positive inotropic and chronotropic effects and is commonly used in patients who cannot exercise or achieve an adequate heart rate res...

    journal_title:Clinical cardiology

    pub_type: 杂志文章,评审

    doi:10.1002/clc.4960230804

    authors: Usher BW Jr,O'Brien TX

    更新日期:2000-08-01 00:00:00