Abstract 15219: Statin Decision-Making Since the 2013 AHA/ACC Cholesterol Guidelines: Do Clinicians Do What They Say?

Background: The 2013 ACC/AHA cholesterol guidelines recommend statin treatment based on patients’ predicted atherosclerotic cardiovascular disease (ASCVD) risk instead of low density lipoprotein (LDL) levels. The extent to which these guidelines have been adopted by clinicians and implemented in practice is unknown. Methods: The PALM Registry surveyed clinicians about whether they would prescribe statins for primary prevention in 3 hypothetical scenarios: 1) diabetes; 2) high ASCVD risk (>7.5%) with high cholesterol (LDL≥130 mg/dL); or 3) low ASCVD risk (<7.5%) with high cholesterol (LDL 130-189 mg/dL). We examined agreement between survey responses and observed statin use rates in the 2,327 PALM Registry patients with similar conditions. Logistic regression assessed whether clinicians who would treat in the hypothetical scenario were more likely to treat in actual practice. Results: Among 774 surveyed clinicians, 84.5% reported they were likely to prescribe a statin to a diabetic patient, 92.9% to a high...