ArticleJournal of clinical lipidology
The use of structured data elements to identify ASCVD patients with statin-associated side effects: Insights from the Department of Veterans Affairs.
Article in Journal of clinical lipidology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- Therapeutic inertia in statin therapy for secondary prevention after percutaneous coronary intervention: a nationwide population-based cohort study.BMC cardiovascular disorders · 2025Observational
- Achievement of guideline-based lipid goals among very-high-risk patients with atherosclerotic cardiovascular disease and type 2 diabetes: results in 213,380 individuals from the cvMOBIUS2 registry.American journal of preventive cardiology · 2025Article
- Monoclonal Antibodies, Gene Silencing and Gene Editing (CRISPR) Therapies for the Treatment of Hyperlipidemia-The Future Is Here.Pharmaceutics · 2023Review
- Documented Adverse Drug Reactions and Discontinuation of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in Chronic Kidney Disease.American journal of nephrology · 2023Article
- Validation and Improvement of a Convolutional Neural Network to Predict the Involved Pathology in a Head and Neck Surgery Cohort.International journal of environmental research and public health · 2022Article
- Improving Familial Hypercholesterolemia Diagnosis Using an EMR-based Hybrid Diagnostic Model.The Journal of clinical endocrinology and metabolism · 2022Article
- Leveraging structured and unstructured electronic health record data to detect reasons for suboptimal statin therapy use in patients with atherosclerotic cardiovascular disease.American journal of preventive cardiology · 2022Article
- Transatlantic guidelines on dyslipidemia and cardiovascular risk: key differences across the pond.Current opinion in endocrinology, diabetes, and obesity · 2021Review
- Combining structured and unstructured data in EMRs to create clinically-defined EMR-derived cohorts.BMC medical informatics and decision making · 2021Article
- Highlights from Studies Presented at the American Heart Association Scientific Session 2020: Navigating New Roads in Prevention.Current atherosclerosis reports · 2021Review
- Shared Decisions: A Qualitative Study on Clinician and Patient Perspectives on Statin Therapy and Statin-Associated Side Effects.Journal of the American Heart Association · 2020Article
- Evaluation of Aspirin and Statin Therapy Use and Adherence in Patients With Premature Atherosclerotic Cardiovascular Disease.JAMA network open · 2020Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundAccurate identification of patients with statin-associated side effects (SASEs) is critical for health care systems to institute strategies to improve guideline-concordant statin use.
objectiveThe objective of this study was to determine whether adverse drug reaction (ADR) entry by clinicians in the electronic medical record can accurately identify SASEs.
methodsWe identified 1,248,214 atherosclerotic cardiovascular disease (ASCVD) patients seeking care in the Department of Veterans Affairs. Using an ADR data repository, we identified SASEs in 15 major symptom categories. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were assessed using a chart review of 256 ASCVD patients with identified SASEs, who were not on high-intensity statin therapy.
resultsWe identified 171,189 patients (13.71%) with documented SASEs over a 15-year period (9.9%, 2.7%, and 1.1% to 1, 2, or >2 statins, respectively). Statin use, high-intensity statin use, low-density lipoprotein cholesterol, and non-high-density lipoprotein cholesterol levels were 72%, 28.1%, 99 mg/dL, and 129 mg/dL among those with vs 81%, 31.1%, 84 mg/dL, and 111 mg/dL among those without SASEs. Progressively lower statin and high-intensity statin use, and higher low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol levels were noted among those with SASEs to 1, 2, or >2 statins. Two-thirds of SASEs were related to muscle symptoms. Sensitivity, specificity, PPV, NPV compared with manual chart review were 63.4%, 100%, 100%, and 85.3%, respectively.
conclusionA strategy of using ADR entry in the electronic medical record is feasible to identify SASEs with modest sensitivity and NPV but high specificity and PPV. Health care systems can use this strategy to identify ASCVD patients with SASEs and operationalize efforts to improve guideline-concordant lipid-lowering therapy use in such patients. The sensitivity of this approach can be further enhanced by the use of unstructured text data.
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