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P42 Background: Elevated serum cholesterol levels are  associated with increased risk of acute myocardial infarction (AMI) and  adverse patient outcomes. It is unclear what proportion of patients  have their serum cholesterol measured during hospitalization for AMI  and are treated with lipid lowering therapy. The objectives of this  longitudinal study were to examine trends over a decade long experience  in serum cholesterol ordering practices during hospitalization for AMI  and use of lipid lowering therapy. Methods: Observational  study of 5204 residents of the Worcester, MA, metropolitan area  hospitalized with validated AMI in all greater Worcester hospitals in  seven one-year periods between 1986 and 1997. Results:  Increases in the measurement of serum cholesterol levels during  hospitalization for AMI were observed between 1986 and 1991 after which  time there was a progressive decrease; only 24% of AMI patients in  1997 underwent cholesterol testing. Younger age, male sex, and absence  of a history of cardiovascular disease were associated with an  increased likelihood of serum cholesterol being measured. While the  relative use of lipid lowering therapy increased significantly over  time (0.4% in 1986; 10.7% in 1997), the absolute rate of utilization  of lipid lowering therapy remained low. In patients with an elevated  serum cholesterol (&gt;240 mg/dL), 1.9% received lipid lowering therapy  in 1986 and 36.6% in 1997. Conclusions: These findings  suggest recent declines in the assessment of total cholesterol levels  in patients hospitalized with AMI. While the use of lipid lowering  therapy during hospitalization for AMI has increased over time,  considerable room for improvement remains.

circulation

Temporal Trends (1986-1997) in Cholesterol Assessment and Management Practices in Patients Hospitalized with Acute Myocardial Infarction: A Population-Based Perspective