{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T19:04:56Z","timestamp":1779822296518,"version":"3.53.1"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Population Health and Outcomes"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>While health systems have implemented resources to improve lipid management in people with atherosclerotic cardiovascular disease, the population-level effectiveness is unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Electronic health record data from patients with atherosclerotic cardiovascular disease between January 1, 2021, and December 31, 2023, across 16 US academic health systems were analyzed. Atherosclerotic cardiovascular disease (defined by diagnosis and procedure codes) was established on or before the index date defined as the date of the most recent LDL-C (low-density lipoprotein-cholesterol) or the last day of the study period for those without an LDL-C available. Systems were surveyed to identify lipid management programs (eg, prevention\/lipid clinic, electronic health record\u2013based tools, and lipid management algorithms). Sequential multilevel multivariable logistic regression modeling was used to (1) assess the system-level association between an LDL-C &lt;70 mg\/dL and the presence of lipid management programs, adjusting for patient-level demographic and clinical characteristics, and (2) whether system-level uptake of statin or nonstatin lipid-lowering therapy was associated with an LDL-C &lt;70 mg\/dL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>We included 1\u2009738\u2009042 patients with atherosclerotic cardiovascular disease (median, 88\u2009365 per system; range, 17\u2009086\u20132\u200948\u2009371). About 81% of the health systems had prevention or lipid clinics. The proportion of those on statins ranged from 31.0% to 60.4% across health systems (median, 46.3%). Lower proportions were observed in the use of high-intensity statins (16.2%\u201333.1%), nonstatins (2.6%\u20138.1%), and combination lipid-lowering therapy (1.7%\u20136.3%). Among those with an LDL-C level available (n=890\u2009521), 42.5% had an LDL-C &lt;70 mg\/dL, ranging 35.8% to 49.4% across systems. There was no association between the odds of achieving LDL-C &lt;70 mg\/dL and health system lipid management algorithm, prevention clinics\/lipid clinics, or electronic health record\u2013based tools. Neither system-level high-intensity statin utilization nor nonstatin use was associated with an LDL-C &lt;70 mg\/dL.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Despite variability in lipid management resources and lipid-lowering therapy use across systems, many did not reach an LDL-C &lt;70 mg\/dL, and there was low uptake of lipid-lowering therapy. Innovative implementation strategies are needed for system-level lipid management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circoutcomes.125.012622","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T10:00:17Z","timestamp":1771581617000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Variation in Lipid Management for Atherosclerotic Cardiovascular Disease Across US Health Systems"],"prefix":"10.1161","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2666-7132","authenticated-orcid":true,"given":"Nishant P.","family":"Shah","sequence":"first","affiliation":[{"name":"Division of Cardiology, Duke University School of Medicine, Durham, NC (N.P.S., S.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5415-4721","authenticated-orcid":true,"given":"Eric D.","family":"Peterson","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Texas Southwestern Medical Center, Dallas (E.D.P., Z.A., A.M.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Shrader","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, NC (P.S., S.S., N.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2223-7215","authenticated-orcid":true,"given":"Satoshi","family":"Shoji","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Duke University School of Medicine, Durham, NC (N.P.S., S.S.)."},{"name":"Duke Clinical Research Institute, Durham, NC (P.S., S.S., N.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9905-4855","authenticated-orcid":true,"given":"Nikki","family":"Freeman","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute, Durham, NC (P.S., S.S., N.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7021-7622","authenticated-orcid":true,"given":"Seth S.","family":"Martin","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Johns Hopkins School of Medicine, Baltimore, MD (S.S.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clint","family":"Allred","sequence":"additional","affiliation":[{"name":"Department of Population Health, University of Utah, Salt Lake City (C.A.)."},{"name":"St Luke\u2019s Health Idaho Cardiology Associates, Boise (C.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7848-9781","authenticated-orcid":true,"given":"Soledad","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, Ohio State University, Columbus (S.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1888-9584","authenticated-orcid":true,"given":"Alanna M.","family":"Chamberlain","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (A.M.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1185-555X","authenticated-orcid":true,"given":"Jonathan","family":"Arnold","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Pittsburgh School of Medicine, PA (J.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9071-3287","authenticated-orcid":true,"given":"Michael D.","family":"Shapiro","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Wake Forest University Health Sciences, NC (M.D.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4050-5030","authenticated-orcid":true,"given":"Mark B.","family":"Effron","sequence":"additional","affiliation":[{"name":"Cardiology Department, Xavier Ochsner College of Medicine, New Orleans, LA (M.B.E.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Priest","sequence":"additional","affiliation":[{"name":"Baylor Scott &amp; White Research Institute, Dallas, TX (E.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8978-1565","authenticated-orcid":true,"given":"Mahanaz","family":"Syed","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences, University of Texas Health Science Center, San Antonio (M.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2557-6749","authenticated-orcid":true,"given":"H. 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