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Coronary artery disease| Volume 102, ISSUE 9, P1142-1145, November 01, 2008

Discordance Between Physicians' Estimation of Patient Cardiovascular Risk and Use of Evidence-Based Medical Therapy

Published:August 19, 2008DOI:https://doi.org/10.1016/j.amjcard.2008.06.037
Discordance Between Physicians' Estimation of Patient Cardiovascular Risk and Use of Evidence-Based Medical Therapy
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      Despite clinical trial evidence supporting the use of antiplatelets, angiotensin-converting enzyme inhibitors, and statins for cardiovascular risk reduction in high-risk patients, use of such therapies in real-world outpatients in the prospective Vascular Protection Registry and the Guidelines Oriented Approach to Lipid Lowering Registry was suboptimal (78%, 55%, and 75%, respectively). The most frequent reason physicians cited for nonprescription of statins (33%) was that patients were not high risk enough and/or current guidelines did not support statin use. In conclusion, outpatients at high cardiovascular risk continue to be undertreated as a result of a combination of physician underestimation of cardiovascular risk (knowledge gap) and barriers to implementation of evidence-based therapy (practice gap).
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      Article info

      Publication history

      Published online: August 19, 2008
      Accepted: June 30, 2008
      Received in revised form: June 30, 2008
      Received: January 11, 2008

      Footnotes

      This work was supported by the Canadian Heart Research Centre, Toronto, Ontario, Canada, Pfizer, Kirkland, Quebec, Canada, Sanofi Aventis, Laval, Quebec, Canada, and Astra Zeneca, Mississauga, Canada. Drs. Leiter, Fitchett, Langer, and Goodman have received speaker/consulting honoraria and/or research grant support from the co-sponsors.

      Identification

      DOI: https://doi.org/10.1016/j.amjcard.2008.06.037

      Copyright

      © 2008 Elsevier Inc. Published by Elsevier Inc. All rights reserved.

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