PALM captured detailed information about patients’ prior experiences with lipid‐lowering therapy. Core laboratory lipid panels were performed by LabCorp (Burlington, NC).
Patient sociodemographic characteristics, comorbidities, and current medications including statin use and dosage were abstracted from the medical record by study coordinators at each site. 11 A total of 7938 patients were enrolled from 140 cardiology, primary care, and endocrinology practices in the United States between May 2015 and November 2015. Second, we compared overall statin use, and guideline‐recommended statin therapy and low density lipoprotein cholesterol (LDL‐C) levels, by the underlying ASCVD condition before and after adjusting for differences in patient characteristics, perceptions, and beliefs.ĭetails of the design and conduct of the PALM registry have been previously described. Using PALM registry first we examined differences in patient perceptions of cardiovascular risks, beliefs on the effectiveness and safety of statin drugs, tolerability and reported symptoms following statin use among patients with CeVD only, both CAD and CeVD (CAD&CeVD), or CAD only. The PALM (Patient and Provider Assessment of Lipid Management) registry is a nationwide contemporary outpatient registry of individuals with ASCVD or at high risk for ASCVD in the United States. 4, 5, 6, 7, 8, 9, 10 While appropriate statin therapy is an important goal in patients with CeVD, 3 it is unclear whether CeVD patients are treated differently from those with CAD. 1, 2, 3 Despite the overwhelming evidence that statins are highly beneficial in preventing recurrent ischemic events, secondary prevention patients are often untreated or undertreated with lower‐than‐recommended statin intensity in community practice. There were no significant differences in the use of any statin therapy or guideline‐recommended statin intensity between individuals with CAD&Ce VD and those with CAD only.Ĭurrent lipid guidelines strongly recommend statin therapy for secondary prevention in patients with atherosclerotic cardiovascular disease (ASCVD), including coronary artery disease (CAD) and cerebrovascular disease (CeVD). Individuals with Ce VD only were also less likely to achieve low‐density lipoprotein cholesterol <100 mg/ dL (59.2% versus 69.7% adjusted odds ratio 0.79, 95% CI 0.64–0.99) than individuals with CAD alone. However, patients with Ce VD only were less likely to receive any statin therapy (76.2% versus 86.2% adjusted odds ratio 0.64, 95% CI 0.45–0.91), or guideline‐recommended statin intensity (34.6% versus 50.4% adjusted odds ratio 0.60, 95% CI 0.45–0.81) than those with CAD only. Among individuals with Ce VD only (n=403), CAD only (n=2202), and Ce VD& CAD (n=627), no significant differences were observed in patient‐perceived cardiovascular disease risk, beliefs on cholesterol lowering, or perceived effectiveness and safety of statin therapy. The PALM (Patient and Provider Assessment of Lipid Management) registry collected data on statin use, intensity, and core laboratory low‐density lipoprotein cholesterol levels for 3232 secondary prevention patients treated at 133 US clinics. Stroke: Vascular and Interventional Neurology.Journal of the American Heart Association (JAHA).
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