Effect of 2018 American College of Cardiology/American Heart Association Guideline Change on Statin Prescription for People Living with HIV

• Published in: Preventive medicine reports 2023-06, Vol.33, p.102175-102175, Article 102175
• Main Authors: Pan, Meng, Agovi, Afiba Manza-A., Anikpo, Ifedioranma O., Fasanmi, Esther O., Thompson, Erika L., Reeves, Jaquetta M., Thompson, Caitlin T., Johnson, Marc E., Golub, Vitaly, Ojha, Rohit P.
• Format: Article
• Language: English
• Subjects: Cardiovascular disease; Clinical practice guideline; Evaluation; HIV; Prevention; Regular; Statin
• ISSN: 2211-3355; 2211-3355
• DOI: 10.1016/j.pmedr.2023.102175

•Statin prescription guidelines recently changed for people living with HIV (PLWH).•We estimated that guideline change increased statin prescription by 25% among PLWH.•A sizable proportion of eligible PLWH still were not prescribed statins.•Strategies are needed to enhance adoption of statin prescription guidelines. The American College of Cardiology (ACC)/American Heart Association (AHA) guidelines were updated in 2018 to explicitly recommend statin use for primary cardiovascular disease prevention among people living with HIV (PLWH), but little is known about the effect of this guideline change. We aimed to assess the effect of the 2018 ACC/AHA guideline change on statin prescription among PLWH. We used data from an institutional HIV registry to identify PLWH aged 40–75 years, engaged in HIV care between June 2016 and May 2021, had a LDL cholesterol between 70 and 189 mg/dl, 10-year atherosclerotic cardiovascular disease (ASCVD) risk score ≥7.5%, no prior statin prescription, and no history of diabetes or ASCVD. Our outcome of interest was a new statin prescription within 12 months of eligibility. We estimated standardized risk difference (RD) with 95% confidence limits (CL) by comparing prescription probabilities before and after guideline change. Our study population comprised 251 PLWH (171 before, 80 after the guideline change), of whom 57% were aged