Coronary care physician 1994-2000 adherence to 1993 National Cholesterol Education Program diet and lipid...

The 1993 NCEP recommended phase 2 diets and < or = 100 mg/dL LDL goals for all atherosclerotic patients. We reviewed Washington, DC physician 1994-2000 use of these recommendations for coronary care unit (CCU) patients. Questionnaires, chart reviews and interviews of cardiologists, residents and dietitians showed > 80% of CCU physicians ignored NCEP dietary recommendations. NCEP 1 diets were ordered for approximately 80% of patients. NCEP 2, AHA 3 or vegetarian diets were used for < 20%. Statins were reported for approximately 25% of patients in 1994-95 but were on < 20% of charts in 1996-7. This increased to approximately 58% by 2000. NCEP 2 diets lower cholesterol approximately 5%, rarely reaching LDL goals, and < 20% of CHD patients on anti-lipid therapy were at NCEP LDL goals by 1999. With 1-year post-myocardial infarction 34% mortality and 53% readmission rates, we need early and much more aggressive anti-lipid diets and drugs in treating these patients.