PS126. Vascular Surgeons Can Improve the Cardiovascular Health of Patients With Clinical Atherosclerotic Cardiovascular Disease by Implementing an Intensive Lipid-Lowering Regimen and Providing Smoke Cessation Counseling

To assess the impact of a vascular surgery-led program to improve the cardiovascular risk of patients with clinical atherosclerotic cardiovascular disease (ASCVD) by implementing an intensive lipid-lowering regimen and providing smoke cessation counseling. The records of all patients seen in a single-center vascular surgery clinic over a 1-month period in November 2013 were retrospectively reviewed till October 1, 2011, when the vascular surgery service implemented a cardiovascular risk reduction program in patients with clinical ASCVD. Included were 144 consecutive patients with a median follow-up of 315 days (range, 0-740 days). Preintervention, the baseline median low-density lipoprotein (LDL) was 86 mg/dL (range, 39-197 mg/dL) and 96 patients (71.1%) had an LDL >70 mg/dL. Fifty-two patients (37%) were current smokers, 41 (71%) smoked heavily (more than one pack per day). Fifty-five percent of patients had documentation that this intervention was administered at the initial vascular surgery encounter after this program was started. The mean lag time to the first vascular surgery encounter with intervention documentation was 117 days (median, 0 days; range 0-721 days). At the latest follow-up, 92 (72%) of the encounters by a vascular surgeon documented that the intervention was administered, final median LDL was 79 mg/dL (range, 31-198 mg/dL), 80 patients (62%) had an LDL >70 mg/dL, and 60 patients (47.2%) had a decrease in their LDL. Patients that had no observed decrease in their LDL had a significantly lower mean level at baseline (82.3; standard deviation, 28.7; range 39-197 mg/dL) compared with those with an observed decrease in LDL (mean, 98.8; standard deviation, 32.8; range, 42-187 mg/dL; P = .003). At the latest follow-up, 41 patients (31.5%) were currently smoking, 21 (43.7%) of whom smoked heavily (more than one pack per day). Vascular surgeons can improve the cardiovascular health of their patients by implementing a program of intensive lipid control and smoking cessation in patients with clinical ASCVD. Further studies are needed to determine the impact on cardiovascular event rates.