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