Treatment Disparities in the Management of ASCVD

EP: 1.The Burden of ASCVD and Evidence-Based Guidelines

EP: 2.A Patient’s Post-MI Journey

EP: 3.Improving the Care Continuum

EP: 4.Residual Cardiovascular Risk

EP: 5.Who is an Ideal Patient for Early Intensive Lipid Lowering?

EP: 6.Finding the Optimal Statin Dose

EP: 7.Therapy Beyond Statins in the Inpatient Setting

EP: 8.Using Adjunct Therapies in LDL Management

EP: 9.Ensuring Continuity of Care for the ASCVD Patient

EP: 10.Unmet Needs in Lipid Management

EP: 11.Defining “Optimal Care” for ASCVD Within Health Systems

EP: 12.What Does a Multidisciplinary Team Look Like?

EP: 13.The Future of LDL Management for Patients With High-Risk ASCVD

EP: 14.Enhancing Patient Care Through Guideline Adherence

EP: 15.Improving Access to PCSK9 Inhibitors in the Inpatient Setting

EP: 16.Appropriate ASCVD Treatment Outside of Closed Health Systems

EP: 17.Utilizing Quality Metrics in ASCVD

EP: 18.Improving Patient and Provider Engagement

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EP: 19.Treatment Disparities in the Management of ASCVD

Leandro N. Slipczuk, MD, PhD: When we talk about health care disparities in ASCVD [atherosclerotic cardiovascular disease], that’s something we see here often. It’s something I’ve seen in my prior hospital in North Philadelphia [Pennsylvania] as well. Here in the Bronx [New York], we see it. But it happens in every city in United States. The first disparity that doesn’t involve ethnicity, race, or gender is knowledge. [We need to get] knowledge to patients and providers about the importance of identifying very high-risk patients and of reaching very low LDL [low-density lipoprotein]. Providers still get asked if it’s safe to reach a very low LDL. There are a lot of data that snow that it’s safe. So the first disparity is knowledge. In the modern area, there’s a lot of information on the internet. Institutions like AHA [American Heart Association] and ACC [American College of Cardiology] and journals…are trying to bring information to patients, providers, physicians, and nurse practitioners. That’s the first approach to this disparity.

The second one is having institutions in the safety net that they deal with patients who may not have the resources, to make sure there are ways around it. For example, we have a partnership with a company to approach patients with very high ASCVD risk. [It will] find someone who can guide patients into programs. There are so many programs. We have many programs in New York to assist people, but there are also programs from the pharmaceutical companies and from the NLA [National Lipid Association] to assist patients who don’t have the money to find the right therapy. Having that information and having someone who can guide the patient and show them is very important.

We’re learning more on this, and all the disparities have been tested; for example, for residual risk and understanding residual risk, such as lipoprotein. We know that this changes in different ethnicities, but it’s very important to have lipid clinics and metabolic clinics where this gets tested and to make sure we understand the receivable risk in our patients and how to manage.

This transcript has been edited for clarity.