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Cited by 14Lipoproteins and Cardiovascular HealthHealth disparities and outcomesCancer, Lipids, and Metabolism

Association Between Poverty and Appropriate Statin Prescription for the Treatment of Hyperlipidemia in the United States: An Analysis From the ACC NCDR PINNACLE Registry

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Tanguturi, Varsha K., Kennedy, Kevin F., Virani, Salim S., Maddox, Thomas M., Armstrong, Katrina, Wasfy, Jason H.·2020·Cardiovascular Revascularization Medicine
DOI 10.1016/j.carrev.2019.12.026
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Abstract

BACKGROUND Poverty is associated with a higher risk of myocardial infarction and cardiac death, both of which are decreased by treatment of hyperlipidemia. There may be differences in the appropriate treatment of hyperlipidemia between richer and poorer Americans. In this study, we aimed to evaluate the association between income level and appropriate lipid-lowering therapy. METHODS We identified outpatient visits in the National Cardiovascular Data Registry's Practice Innovation and Clinical Excellence (PINNACLE) Registry and determined appropriateness of lipid-lowering therapy among patients in different income quintiles (Quintile 5 being the highest income quintile). Logistic regression at the patient level was performed to evaluate the independent association of income and the primary outcome of appropriate statin therapy. The analysis was repeated before and after November 2013 given a change in guideline definitions. RESULTS The study included 1,655,723 patients. Overall, 68-73% of patients were treated appropriately under the ATP III Guidelines and 57-62% of patients were treated appropriately under the ACC/AHA Guidelines. Patients in the wealthiest quintile had higher odds of appropriate statin therapy under both guidelines relative to patients in the poorest quintile (OR 1.06 [1.05-1.07] for ATP III and OR 1.03 [1.01-1.04] for ACC/AHA). In the whole sample, patients with higher estimated income had a small but significant increased likelihood of appropriate statin therapy (point-biserial correlation 0.035 [p < 0.001] for ATP III and 0.026 [p < 0.001] for ACC/AHA). CONCLUSIONS Here we describe a small association between appropriate statin use and income. Further investigation into barriers in the use of evidence-based therapies in poorer populations is needed.

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    Cited work 10.1002/14651858.cd009217.pub2 · retraction date not known · this paper published 2020-08

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Authors
Tanguturi, V. K., Kennedy, K. F., Virani, S. S., Maddox, T. M., Armstrong, K., & Wasfy, J. H.
Affiliations
  • Harvard University (US)
  • Saint Luke's Hospital (US)
  • Michael E. DeBakey VA Medical Center (US)
  • Washington University in St. Louis (US)
Corresponding author
  • Tanguturi, Varsha K.
  • Wasfy, Jason H.
ORCID
Venue
Cardiovascular Revascularization Medicine
Publisher
Elsevier BV
Published
2020-08
Volume
21
Issue
8
Pages
1016-1021
ISSN
1553-8389 (ISSN-L)
DOI
10.1016/j.carrev.2019.12.026
OpenAlex
W2997829667
Semantic Scholar
2ba60534b2c31b8968a871b745ed8c7fa5bf8255
Cited by
14
References
31
Citations by year
2026: 1 · 2025: 4 · 2024: 3 · 2023: 2 · 2022: 2 · 2020: 2
FWCI
0.87
Type
journal article
Language
en
Open access
Licence
Locations
  • Cardiovascular revascularization medicine (publishedVersion)
  • PubMed (publishedVersion)
  • eCommons - AKU (Aga Khan University) (submittedVersion, cc-by-nc-nd)
Funders
  • American College of Cardiology
  • American Heart Association (18CDA34110215)
  • National Institutes of Health (KL2 TR001100)
Topics
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
  • Social Sciences › Health › Health disparities and outcomes
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Lipids, and Metabolism
Keywords
poverty, income level, statin therapy, hyperlipidemia, health disparities, ATP III guidelines, ACC/AHA guidelines, PINNACLE registry, cardiovascular disease prevention, guideline adherence
MeSH terms
Aged, Aged, 80 and over, Female, Humans, Hyperlipidemias, Income, Male, Middle Aged, Practice Patterns, Physicians', Poverty, Registries, Risk Factors, United States, Practice Guidelines as Topic, Risk Assessment, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Guideline Adherence, Healthcare Disparities, Social Determinants of Health

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