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Articles by Robert L. Ohsfeldt
Total Records ( 2 ) for Robert L. Ohsfeldt
  Michael H. Davidson , Kathleen M. Fox , Sanjay K. Gandhi , Robert L. Ohsfeldt and James M. McKenney


We sought to examine the diagnoses and medical management patterns of patients before the incidence of a cardiovascular (CV) event.


A retrospective study of claims data from a national managed care plan was conducted. Eligible patients had a myocardial infarction, stroke, or revascularization between January 1, 2004 and December 31, 2005, and at least 3 years of continuous enrollment before the CV event. Patients were stratified by whether or not they had a diagnosis of atherosclerosis in the 3 years before the CV event. Diagnostic testing, lipid monitoring, and statin treatment patterns were assessed during the 3-year period before the CV event.


There were 16,543 patients with a CV event, and 65% had no previous diagnosis of atherosclerosis. For all patients, 58% were men, and mean age was 60 years. Angiography or cardiac imaging was performed in <3% of patients, and cardiac stress testing was performed in 13% of patients before the event. Only 19% of patients had ≥1 lipid test in the 12 months and 32% in the 3 years before the event, and their 12-month mean low-density lipoprotein cholesterol was 113 mg/dL. Thirty-four percent of patients were on statin therapy within the 3 years before event. The patient subgroup diagnosed with atherosclerosis had significantly more patients with cardiac testing, lipid monitoring, and statin therapy compared with patients with no previous diagnosis of atherosclerosis.


These results from an actual clinical practice dataset indicate opportunities for improved detection and management of underlying atherosclerotic heart disease to avoid future cardiovascular events.

  James McKenney , Sanjay K. Gandhi , Kathleen M. Fox and Robert L. Ohsfeldt


Clinical guidelines have recommended a LDL-C goal of <100 mg/dL for high-risk individuals and lipid-modifying therapy for patients not reaching this goal.


This investigation assessed low-density lipoprotein cholesterol (LDL-C) levels and treatment patterns among patients diagnosed with atherosclerosis with or without a previous cardiovascular disease (CVD) event.


We conducted a retrospective study by using claims data from a national health plan that included patients with ≥ 1 medical claim for atherosclerosis (ICD-9 of 440.xx, 414.x, 437.0, 437.1, or 437.3) between January 2004 and March 2006. Use of lipid-modifying medications at the time of diagnosis and thereafter, patient demographics, comorbid conditions, baseline, and postdiagnosis LDL-C were assessed.


There were 311,567 patients who had an atherosclerosis ICD-9 code, 46% of whom had a previous CVD event. Among patients with an atherosclerosis diagnosis and CVD event, lipid-modifying therapy was received by 50% before diagnosis and 57% after diagnosis, compared with 37% before and 48% after diagnosis for patients with an atherosclerosis diagnosis and no previous CVD event. Of the patients with baseline LDL-C (15%, n=46,923), 44% had an LDL-C <100 mg/dL at diagnosis; of those with LDL-C ≥ 100 mg/dL, only 54% received lipid-modifying therapy and only 64% achieved an LDL-C <100 mg/dL in the 12 succeeding months. Among patients with baseline and postdiagnosis LDL-C values (n=24,724), 55% had a baseline LDL-C ≥ 100 mg/dL and 46% had a baseline non-HDL-C ≥ 130 mg/dL.


In conclusion, many patients in a managed care plan diagnosed with atherosclerosis with or without a previous CVD event present opportunities for better lipid management. Healthcare providers should evaluate more aggressive lipid management interventions for these patients for potential downstream cardiovascular benefits.

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