2136. Application of the 2013 American College of Cardiology/American Heart Association Blood Cholesterol Guidelines in HIV patients in an Ambulatory Care Setting
Session: Poster Abstract Session: HIV Cardiovascular Disease, Lipids, and Diabetes
Saturday, October 29, 2016
Room: Poster Hall
Posters
  • 2016_IDweek_2136-Gorden, Application of the 2013 ACC-AHA cholesterol guidelines in HIV patients in an ambulatory care setting.pdf (519.9 kB)
  • Background: Given the increased risk of cardiovascular events in HIV-positive patients, appropriate application of the 2013 American College of Cardiology/American Heart Association blood cholesterol guidelines may significantly impact morbidity and mortality in this population. We sought to characterize the cardiovascular risk management of HIV-positive patients receiving care within the largest HIV clinic in New Orleans, LA. The primary goal was to identify the proportion of statin-eligible patients who were prescribed a statin in accordance with these guidelines.

    Methods: This study was approved by the Xavier University of Louisiana Institutional Review Board. Eligible patients were aged 40 – 75 years old, with at least one primary care visit to the University Medical Center New Orleans Infectious Disease Center between December 2013 and November 2015. Statin eligibility was determined based on the 2013 cholesterol guidelines. Descriptive statistics and multiple logistic regression were used to analyze demographics and secondary objectives.

    Results: A random sample of 250 patients were reviewed (62% male, 80% African-American). From this sample, 23 were excluded due to missing data. A total of 127 patients were determined to be statin-eligible; main reasons for statin-ineligibility included: 10-year risk <7.5% (n=64) and low-density lipoprotein <70 mg/dL (n=29). Among statin-eligible patients, 59.8% (n=76) were prescribed a statin. Patient factors associated with increased statin prescribing included increasing age (OR 1.34 (0.79-2.26)) and female gender (OR 1.66 (0.75-3.67)), whereas having less subsidized insurance was associated with decreased statin prescribing (OR 0.96 (0.74-1.24); none of these factors reached statistical significance. Of the statin-eligible patients who did not receive a statin, 82% had a high 10-year risk  7.5%; 35.3% (n=18) of these patients were persistently viremic (>400 copies/mL) throughout the study period.

    Conclusion: Despite the majority of statin-eligible patients receiving a statin, the results from this study demonstrate an opportunity for improved patient care. The inclusion of an automatically calculated risk assessment may improve statin prescribing practices for HIV patients.

    Brittany Gorden, PharmD1, Lori Gordon, PharmD1,2, Maria Frontini, DVM, PhD, MSc, MPH2, Daniel Sarpong, PhD1, Jason Halperin, MD, MPH3, Linda Mihm, PharmD1,3 and Kristi Rapp, PharmD1, (1)Xavier University of Louisiana, New Orleans, LA, (2)Louisiana State University, New Orleans, LA, (3)Tulane University, New Orleans, LA

    Disclosures:

    B. Gorden, None

    L. Gordon, None

    M. Frontini, None

    D. Sarpong, None

    J. Halperin, None

    L. Mihm, None

    K. Rapp, None

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