Underuse of statins for secondary prevention of atherosclerotic cardiovascular disease events among ambulatory surgical patients

Opportunities Beyond the Anesthesiology Department: Broader Impact Through Broader Thinking

“…Similarly, in the preoperative clinic, anesthesiologists work to optimize a patient's preexisting cardiovascular conditions to decrease perioperative risk. 40 However, if such principles were applied more broadly across the longitudinal health timeline of patients undergoing surgical procedures, anesthesiologists may establish a perioperative paradigm for the identification and primary care follow-up of patients with undiagnosed or undertreated hypertension, 41,42 hyperlipidemia, 43 or heart failure. 44 This reframing of anesthesiologists as physicians who are engaged with improving the longitudinal cardiovascular care of their patients-in collaboration with primary care physicians and cardiologists-provides an opportunity to improve the health trajectories of surgical patients beyond the day of surgery and may significantly enhance the public health impact of the anesthesiologist and operative episode.…”

Two Decades of Overuse and Underuse of Interventions for Primary and Secondary Prevention of Cardiovascular Diseases: A Systematic Review

“…Other publications not included in this review as they did not make reference to guidelines have reported overuse and underuse trends which are similar to our findings. Underuse of statins, estimated as non-prescribing in the presence of clinically diagnosed atherosclerotic CVD was estimated at 39.3% among surgical outpatients in the US (36). A retrospective analysis of 157,000 claims database also uncovered that despite a trend of increased statins use since 2002, almost half (41.9%) of the people with diagnosed CVD had not been prescribed it in the 2012-2013 cohort.…”

Assessing the Prevalence of Medical Optimization Therapy in Vascular Surgery Clinics

“…Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of mortality in the US and highly prevalent among veterans . Optimal medical therapy (OMT), including lipid-lowering and antiplatelet therapies, prevents secondary ASCVD events (amputation, stroke, myocardial ischemia) and mortality but remains underprescribed . Evidence-based OMT guideline implementation is poor for noncoronary ASCVD, especially peripheral artery disease (PAD), where only 25% of veterans achieved OMT before undergoing lower-extremity bypass .…”