Related Experiment Video
Updated: Jun 22, 2025
Cell-free Biochemical Fluorometric Enzymatic Assay for High-throughput Measurement of Lipid Peroxidation in High Density Lipoprotein
Published on: October 12, 2017
Low-Density Lipoprotein Cholesterol Testing Following Myocardial Infarction Hospitalization Among Medicare
Lisandro D Colantonio1, Zhixin Wang1, Jenna Jones2
1Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Insights
Low-density lipoprotein cholesterol (LDL-C) testing after myocardial infarction (MI) was low among Medicare beneficiaries. This study highlights a missed opportunity for optimizing cardiovascular risk reduction therapies.
Area of Science:
- Cardiovascular Medicine
- Health Services Research
- Public Health
Background:
- Low-density lipoprotein cholesterol (LDL-C) is crucial for guiding lipid-lowering therapy post-myocardial infarction (MI).
- Inadequate LDL-C testing after MI represents a significant missed opportunity for cardiovascular risk management.
Purpose of the Study:
- To determine the proportion of Medicare beneficiaries who underwent LDL-C testing within 90 days of MI hospital discharge.
- To analyze disparities in LDL-C testing rates across demographic groups and geographic regions.
Main Methods:
- Retrospective cohort study of Medicare beneficiaries aged 66+ with MI hospitalizations (2016-2020).
- Analysis included fee-for-service (FFS) beneficiaries with and without pharmacy benefits, and Medicare Advantage (MA) enrollees.
- LDL-C testing proportion was estimated using competing risk of death analysis.
Main Results:
- Only 29.9% of FFS beneficiaries with pharmacy benefits had LDL-C measured within 90 days post-MI.
- Testing rates varied by race/ethnicity (26.0% Black to 33.8% Hispanic) and region (23.4% West North Central to 36.4% Middle Atlantic).
- Rates were 26.9% for FFS without pharmacy benefits and 28.6% for MA enrollees.
Conclusions:
- LDL-C testing rates within 90 days post-MI discharge are low among Medicare beneficiaries.
- Suboptimal testing suggests a need for improved adherence to guidelines for cardiovascular risk management.
Background:
Low-density lipoprotein cholesterol (LDL-C) is used to guide lipid-lowering therapy after a myocardial infarction (MI). Lack of LDL-C testing represents a missed opportunity for optimizing therapy and reducing cardiovascular risk.
Objectives:
The purpose of this study was to estimate the proportion of Medicare beneficiaries who had their LDL-C measured within 90 days following MI hospital discharge.
Methods:
We conducted a retrospective cohort study of Medicare beneficiaries ≥66 years of age with an MI hospitalization between 2016 and 2020. The primary analysis used data from all beneficiaries with fee-for-service coverage and pharmacy benefits (532,767 MI hospitalizations). In secondary analyses, we used data from a 5% random sample of beneficiaries with fee-for-service coverage without pharmacy benefits (10,394 MI hospitalizations), and from beneficiaries with Medicare Advantage (176,268 MI hospitalizations). The proportion of beneficiaries who had their LDL-C measured following MI hospital discharge was estimated accounting for the competing risk of death.
Results:
In the primary analysis (mean age 76.9 years, 84.4% non-Hispanic White), 29.9% of beneficiaries had their LDL-C measured within 90 days following MI hospital discharge. Among Hispanic, Asian, non-Hispanic White, and non-Hispanic Black beneficiaries, the 90-day postdischarge LDL-C testing was 33.8%, 32.5%, 30.0%, and 26.0%, respectively. Postdischarge LDL-C testing within 90 days was highest in the Middle Atlantic (36.4%) and lowest in the West North Central (23.4%) U.S. regions. In secondary analyses, the 90-day postdischarge LDL-C testing was 26.9% among beneficiaries with fee-for-service coverage without pharmacy benefits, and 28.6% among beneficiaries with Medicare Advantage coverage.
Conclusions:
LDL-C testing following MI hospital discharge among Medicare beneficiaries was low.
Related Concept Videos
01:25Blood Studies for Cardiovascular System III: Serum Lipid Profile
Serum lipids are fats and fatty substances in the blood and are crucial for various bodily functions, including energy storage, cellular structure, and hormone production. Serum lipids consist of cholesterol, triglycerides, and phospholipids.
Cholesterol is a soft, fat-like substance found in all body cells. It is crucial for producing hormones, vitamin D, and substances that aid...
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
01:20Lipid-Lowering Drugs: Statins and Miscellaneous Agents