Recommended Citation
Koza AL, Gogineni V, Bajwa T, Allaqaband S, Boulware D, Jan MF. How Low Can We Go? Trends in Cholesterol Management after Coronary Revascularization Across a Multi-Center Health System. Presented at Scientific Day; May 20, 2026; Milwaukee, WI.
Abstract
Background/Significance:
Cholesterol management is a well-studied secondary prevention measure to mitigate the risk of procedural failure and future cardiovascular events after percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG).
Purpose:
This study sought to characterize the level of adherence to cholesterol-lowering regimens in post-PCI and post-CABG patients across Advocate Aurora Health (AAH) medical institutions in hopes of improving knowledge about adherence to secondary prevention cholesterol guidelines for those at risk after coronary artery revascularization at AAH medical centers.
Methods:
This is a retrospective study with 22,060 patients who were eligible for review. The patients used lipid-lowering therapy as secondary risk reduction after PCI or CABG from September 2011 to September 2023 across all 25 AAH medical centers located in Wisconsin and Illinois. The primary goal was to evaluate various post-revascularization low-density lipoprotein (LDL) levels: those with LDL≥100 versus LDL< 100, LDL≥70 versus LDL< 70, and LDL≥55 versus LDL < 55 after revascularization. Secondary analyses included patient demographics, medical conditions associated with increased cardiovascular risk, and prevalence of non-statin therapy usage. The Chi-square test or Fisher’s exact test was used to compare the groups for categorical variables, and the Wilcoxon Rank Sum test was used to compare the groups for numerical variables. Confidence intervals (95%) were also used with the descriptive statistics to describe the characteristics of the cohorts.
Results:
Those in the LDL ≥100 and ≥70 groups had greater prevalence of females, a history of myocardial infarction, and no tobacco use history. Those in the LDL <100, <70, <55 groups had more congestive heart failure, diabetes, hypertension, peripheral arterial disease, chronic kidney disease, atrial fibrillation, and cancer. Interestingly, only the prevalence of stroke was statistically higher in the LDL <55 group vs LDL >55 group, 11.7% vs 10.8% respectively. American Indian or Alaskan ethnicity was more prevalent in LDL <100, <70, <55 groups whereas Hispanic ethnicity was more prevalent in LDL <70 and <55 groups. Groups with LDL ≥ 100, ≥70, and ≥55 had greater use of ezetimibe and evolocumab.
Conclusion:
Those with more cardiovascular risk factors identified were able to achieve lower LDL levels. Patients with higher post-revascularization LDL levels had a greater prevalence of additional therapies beyond statins.
Presentation Notes
Presented at Scientific Day; May 20, 2026; Milwaukee, WI.
Full Text of Presentation
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Document Type
Oral/Podium Presentation
How Low Can We Go? Trends in Cholesterol Management after Coronary Revascularization Across a Multi-Center Health System
Background/Significance:
Cholesterol management is a well-studied secondary prevention measure to mitigate the risk of procedural failure and future cardiovascular events after percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG).
Purpose:
This study sought to characterize the level of adherence to cholesterol-lowering regimens in post-PCI and post-CABG patients across Advocate Aurora Health (AAH) medical institutions in hopes of improving knowledge about adherence to secondary prevention cholesterol guidelines for those at risk after coronary artery revascularization at AAH medical centers.
Methods:
This is a retrospective study with 22,060 patients who were eligible for review. The patients used lipid-lowering therapy as secondary risk reduction after PCI or CABG from September 2011 to September 2023 across all 25 AAH medical centers located in Wisconsin and Illinois. The primary goal was to evaluate various post-revascularization low-density lipoprotein (LDL) levels: those with LDL≥100 versus LDL< 100, LDL≥70 versus LDL< 70, and LDL≥55 versus LDL < 55 after revascularization. Secondary analyses included patient demographics, medical conditions associated with increased cardiovascular risk, and prevalence of non-statin therapy usage. The Chi-square test or Fisher’s exact test was used to compare the groups for categorical variables, and the Wilcoxon Rank Sum test was used to compare the groups for numerical variables. Confidence intervals (95%) were also used with the descriptive statistics to describe the characteristics of the cohorts.
Results:
Those in the LDL ≥100 and ≥70 groups had greater prevalence of females, a history of myocardial infarction, and no tobacco use history. Those in the LDL <100, <70, <55 groups had more congestive heart failure, diabetes, hypertension, peripheral arterial disease, chronic kidney disease, atrial fibrillation, and cancer. Interestingly, only the prevalence of stroke was statistically higher in the LDL <55 group vs LDL >55 group, 11.7% vs 10.8% respectively. American Indian or Alaskan ethnicity was more prevalent in LDL <100, <70, <55 groups whereas Hispanic ethnicity was more prevalent in LDL <70 and <55 groups. Groups with LDL ≥ 100, ≥70, and ≥55 had greater use of ezetimibe and evolocumab.
Conclusion:
Those with more cardiovascular risk factors identified were able to achieve lower LDL levels. Patients with higher post-revascularization LDL levels had a greater prevalence of additional therapies beyond statins.
Affiliations
Aurora St. Luke’s Medical Center