Variation in statin prescription among veterans with HIV and known atherosclerotic cardiovascular disease

Clinical Outcomes After Acute Coronary Syndromes or Revascularization Among People Living With HIV

“…Of note, our study found suboptimal statin prescription in patients living with HIV after ACS or revascularization, which is consistent with results of other retrospective studies. 11,18,19,26,28,[38][39][40][41][42] These findings and those of the Evaluating the Use of Pitavastatin to Reduce the Risk of Cardiovascular Disease in HIV-Infected Adults (REPRIEVE) trial, 14 which demonstrated the benefits of pitavastatin for primary prevention of atherosclerotic cardiovascular disease among patients living with HIV, highlight the need for a concerted effort to improve guideline-directed statin prescription and adherence among these patients. 43 Additionally, the higher prevalence of smoking and higher triglyceride levels we found among patients living with HIV highlight areas for optimization, with the goal of improving secondary prevention of atherosclerotic cardiovascular disease.…”

“…30,31 All were retrospective cohort studies except for 3 prospective studies (Table 1). 11,26,30 Details of patient characteristics and outcomes by study are presented in Table 1 high-density lipoprotein cholesterol (40 [26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] vs 46 [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46] mg/dL; P = .03) levels. (To convert triglycerides and cholesterol to millimoles per liter, multiply by 0.0113 and 0.0259, respectively.)…”

“… 36 , 51 , 52 , 53 Addressing this latter aspect is critically important to improve secondary outcomes of CVD in patients living with HIV because despite increased prescription rates for cardioprotective medications, patients living with HIV have been found to be less likely to fill these medications. 38 , 42 , 52 A multifaceted or multidisciplinary intervention to address psychosocial barriers to cardiovascular care may have the potential to limit mortality and morbidity after ACS or PCI for patients living with HIV.…”

Nurse-Led Strategy to Improve Blood Pressure and Cholesterol Level Among People With HIV

“…Implementation of strategies to overcome these barriers is needed to increase risk factor control and ultimately reduce clinical ASCVD events. On a population level, high blood pressure (BP) and high cholesterol level are 2 leading factors in myocardial infarction among PWH in North America, yet appropriate management of these conditions is suboptimal and lags behind management in the general population . Using a human-centered design approach, our team engaged PWH and their care practitioners to develop and adapt EXTRA-CVD (A Nurse-Led Intervention to Extend the HIV Treatment Cascade for Cardiovascular Disease Prevention).…”

“…On a population level, high blood pressure (BP) and high cholesterol level are 2 leading factors in myocardial infarction among PWH in North America, 4 yet appropriate management of these conditions is suboptimal and lags behind management in the general population. 5 , 6 , 7 Using a human-centered design approach, 8 our team engaged PWH and their care practitioners to develop and adapt EXTRA-CVD (A Nurse-Led Intervention to Extend the HIV Treatment Cascade for Cardiovascular Disease Prevention). The premise of this strategy is that task sharing with nurses has improved and scaled-up HIV and hypertension care in Africa 9 , 10 , 11 and can be adapted to the US context.…”