Identifying high-risk patients with atherosclerotic cardiovascular disease (ASCVD) and optimizing their access to the latest evidence-based treatments for low-density lipoprotein cholesterol (LDL-C) lowering and cardiovascular event risk reduction is the focus of a new national study – TRANSFORM LDL-C Risk – developed by the ACC and Sanofi and Regeneron.

TRANSFORM LDL-C Risk will leverage ACC's PINNACLE Registry to identify patients with established ASCVD, many of whom will qualify as "very high risk" as defined by the 2018 ACC/AHA Guideline on the Management of Blood Cholesterol, in select sites across multiple regions in the U.S. and who meet the evidence-based criteria for enhanced treatments.

The ACC expert consensus decision pathway on non-statin therapies for LDL-C lowering in ASCVD management and the ACC/AHA cholesterol guideline focus on reducing cardiovascular events in patients with a history of ASCVD and who still have high LDL-C levels (above 70 mg/dL) and recommend considering non-statin drugs, including ezetimibe and PCSK9 inhibitors, for these patients who have residual risk.

After an initial national study of current management of ASCVD patients across all PINNACLE practices, physician and patient characteristics, and their adherence to current ACC guidelines and clinical recommendations, practices in specified regions with the largest patient populations currently eligible for additional lipid lowering therapy will be engaged.

Participating sites will receive interventions ranging from targeted clinical action alerts to patient centered medication initiation plans to clinician and patient education programs and self-assessment tools. An ACC quality ambassador will also provide on-the-ground support as needed to help with streamlining processes and addressing barriers to patient access to necessary therapies.

At the end of the program, the pre-determined list of quality variables, including medication adherence and physician prescribing patterns, will be evaluated with the goal of identifying factors that will drive action in high-risk patient cohorts, as well as inform the development of specific tools and resources that can reduce practice and physician pattern variations to break down barriers to care.  The results of the real-world lipid management study will be published so it can be shared more broadly with hospitals, health systems and clinicians to help improve performance related to achieving optimal lipid management.

"Management of lipid disorders has become more complex as new data, drugs and clinical standards around lipid management are introduced. The College has many successful tools and initiatives that have helped our members provide the most advanced and effective lipid management strategies for their patients, but there is more work to be done," said ACC CEO Timothy W. Attebery, DSc, MBA, FACHE. "Through this partnership, we are continuing to drive progress in disease management for this vulnerable, high-risk patient population, who have already been impacted by prior heart attacks, strokes and established cardiovascular disease, and are getting out in front of lipid management by ensuring the right people have the right resources at the right time to provide high quality care."

Keywords: National Cardiovascular Data Registries, PINNACLE Registry, Cholesterol, LDL, Practice Patterns, Physicians', Medication Adherence, Cholesterol, Atherosclerosis, Registries, Stroke, Myocardial Infarction, Risk Reduction Behavior

< Back to Listings