Bold Voices - May 2011 - (Page 13)
AT THE BEDSIDE
Low Use of LLT Common Among Heart Patients
A recent study indicates that most acute coronary syndrome patients discharged from the hospital don’t receive intensive lipid-lowering therapy (LLT), suggesting the need for better implementation of guideline-recommended therapy. patients don’t receive LLT based on the guidelines and are “having coronary events that could have been prevented.” Two reasons for this could be: 1) The guidelines have a number of different recommendations that don’t make clear the high preference for intensive statin therapy; and 2) the guidelines are less than 10 years old and are taking a while to become the norm, Fonarow notes. Dennis Ko, a cardiologist at the Schulich Heart Centre at Sunnybrook Health Sciences Centre, Toronto, says, “People are quite wary to (prescribe) the highest dose of statin therapy for the older and sick patients” for fear of side effects such as muscle breakdown. Ko adds that statins are most important for older patients since these patients have the highest risk of dying from a heart condition, the article adds.
Lipid-lowering therapy guidelines haven’t yet become the norm.
“Use of Intensive Lipid-Lowering Therapy in Patients Hospitalized With Acute Coronary Syndrome: An Analysis of 65,396 Hospitalizations From 344 Hospitals Participating in Get With The Guidelines (GWTG)” in December 2010’s American Heart Journal notes that only 25,036 of the patients studied, or 38.3 percent, received an LLT regimen at discharge. Even among patients with low-density lipoprotein at 130 mg/dL or greater, 50 percent or less received LLT, the study adds. In a related Reuters Health article, senior author Gregg Fonarow, professor of medicine at the David Geffen School of Medicine, University of California, Los Angeles, says that
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AACN BOLD VOICES MAY 2011 13
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