Key result
Tailored lipid optimization strategies linked to ~34% of veterans with ASCVD reaching target LDL-C.
Why the study?
Do tailored lipid optimization strategies improve LDL-C goal attainment in veterans with ASCVD and baseline LDL-C ≥70 mg/dL?
Observational (n=88,778)
Yes
Do tailored lipid optimization strategies improve LDL-C goal attainment in veterans with ASCVD and baseline LDL-C ≥70 mg/dL?
p-value: p=< 0.001
A tailored quality improvement program addressing site-specific barriers significantly improved LDL-C goal attainment and lipid-lowering therapy adherence among veterans with ASCVD.
BACKGROUND: Elevated serum low-density lipoprotein cholesterol (LDL-C) is a major risk factor for atherosclerotic cardiovascular disease (ASCVD). Despite the availability of effective drugs to lower LDL-C, only one-third of veterans with ASCVD have LDL-C treated to goal. OBJECTIVES: This study aimed to determine if a variety of lipid optimization strategies including a health coach tailored to unique barriers and needs can improve: 1) the percentage of veterans with LDL-C <70 mg/dL; and 2) the usage and patients' adherence to any lipid-lowering therapy (LLT). METHODS: Veterans Affairs Lipid Optimization Reimagined Quality Improvement was embedded in the usual clinical care of 167,505 veterans with prevalent ASCVD inclusive of 88,778 veterans with baseline LDL-C ≥70 mg/dL in 50 Veterans Affairs Medical Centers between December 2022 and September 2025. At each Veterans Affairs site, American Heart Association consultants worked with local providers to: 1) identify barriers to lipid management; and 2) implement strategies tailored to the identified barriers. The primary outcome was the proportion of veterans with LDL-C <70 mg/dL between baseline and follow-up LDL-C measurement at 24 months. RESULTS: A total of 88,778 veterans were included in current analyses with mean age of 70.0 (SD: 10.5) years and 6,250 (7.0%) women. Overall, 32.9% of veterans achieved LDL-C <70 mg/dL and for 24,610 veterans with 24-month LDL-C data, 34.4% achieved LDL-C goal (all P < 0.001). The mean LDL-C decreased by 16.6 mg/dL; use of LLT increased from 77.4% to 87.8%; and adherence to any LLT increased from 56.3% to 65.1% between baseline and 24 months. CONCLUSIONS: This program showed that addressing site-specific barriers to lipid management is associated with improved LDL-C among Veterans with ASCVD.
No takes yet. Share an insight, caveat, or question.
Djoussé et al. (2026) conducted an observational in Hypercholesterolemia in ASCVD (n=88,778). Site-specific lipid optimization strategies including a health coach vs. Baseline (pre-intervention) was evaluated on Proportion of veterans with LDL-C <70 mg/dL at 24 months (p=< 0.001). Implementation of site-specific lipid optimization strategies resulted in 34.4% of veterans with ASCVD and baseline LDL-C ≥70 mg/dL achieving an LDL-C <70 mg/dL at 24 months (P<0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: