2026 Southeastern Residency Conference

Abstract
Purpose/Background: Effective lipid management is a cornerstone of secondary prevention in patients with Acute Coronary Syndromes (ACS). The 2025 Guideline for the Management of Patients with ACS emphasizes obtaining a baseline lipid profile on admission, initiating or continuing high-intensity statin therapy during hospitalization, and considering early initiation of non-statin therapies for high-risk patients. Despite these recommendations, adherence to guideline-directed lipid management remains variable. Previous studies suggest baseline lipid panels are not consistently obtained, statins may be underutilized or prescribed at suboptimal intensities, and follow-up lipid testing is often missed. These gaps may delay achievement of lipid targets and increase the risk of recurrent cardiovascular events. This pharmacy project assessed lipid management practices for ACS patients at Huntsville Hospital and guided development of targeted pharmacy interventions to enhance adherence and optimize inpatient lipid care.

Methodology: A single-center, institutional review committee–approved pre-post analysis was conducted in patients hospitalized with acute coronary syndromes (ACS). A random sample of patients admitted between January 2025 and September 2025 with a documented ACS diagnosis was included in the pre-intervention cohort. Patients were excluded if they had a prior history of ACS or incomplete data. A pharmacy-driven intervention was implemented, consisting of targeted education for transitions of care (TOC) pharmacists and promotion of pharmacist-led discharge optimization. A post-intervention cohort was identified using the same inclusion and exclusion criteria, with the additional requirement of a documented TOC discharge note. The primary endpoints were (1) the proportion of patients with a baseline lipid panel obtained within 48 hours of admission and (2) the proportion of patients discharged on optimized guideline-directed lipid-lowering therapy. Baseline demographics and lipid management variables were collected from the electronic medical record. Descriptive statistics were used for analysis.

Results: A total of 250 patients were included in the pre-intervention cohort and 47 patients in the post-intervention cohort. A baseline lipid panel was obtained in 93.6% of patients pre- and post-intervention. Guideline-directed lipid-lowering therapy at discharge improved from 79.2% to 87.2% post-intervention (absolute increase 8.0%), while non-adherence decreased from 20.8% to 12.8%. Pharmacist interventions were documented in 19.6% of post-intervention cases and included contacting providers to recommend addition of non-statin therapy for patients on high-intensity statins with LDL-C >70 mg/dL.

Conclusion: A pharmacy-driven intervention was associated with improved adherence to guideline-directed lipid management in patients hospitalized with ACS. While baseline lipid panel acquisition was high, improvements in discharge therapy optimization were observed. These findings support the role of pharmacist involvement and targeted interventions in improving lipid management in this high-risk population.