ABSTRACT
Background Low-density lipoprotein cholesterol (LDL-C) is used to guide lipid-lowering treatment following hospitalization for myocardial infarction (MI). Lack of LDL-C testing may represent a missed opportunity to prevent recurrent events. Methods We conducted a retrospective cohort study to estimate the cumulative incidence of Medicare beneficiaries, 66 years or older in the Optum Medicare Advantage (MA) or Medicare fee-for-service (FFS) population, who had LDL-C measured post-MI hospital discharge between January 1, 2016, and December 31, 2020. Results LDL-C testing at 30-, 90-, and 365-days post MI was 9.7%, 27.4%, and 66.7%, respectively, among MA patients (n=228,104), and 10.7%, 29.9%, and 65.7%, respectively, among FFS patients (n=532,767). LDL-C testing varied by state (Figure). Among those with MA and FFS, the 90-day LDL-C testing was 34.2% and 33.9% respectively among Hispanic patients, 32.7% and 32.5% respectively among Asian patients, 26.4% and 30.0% respectively among White patients, and 26.4% and 26.1% respectively among Black patients. There was no difference in LDL-C testing from before to after the start of the COVID pandemic. Conclusion LDL-C testing was low following hospital discharge for MI among Medicare beneficiaries with substantial geographic and race disparities. [Formula presented]Copyright © 2023 American College of Cardiology Foundation
ABSTRACT
COVID-19 places people with pre-existing cardiovascular disease at higher risk for mortality. Furthermore, COVID-19 disproportionately affects minorities and those experiencing adverse consequences of social determinants of health. Our report describes the practices put in place to care for underserved patients with heart failure and lessons learned during the COVID-19 pandemic. © Meharry Medical College.