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Quality of diabetes and hyperlipidemia screening before a first myocardial infarction

Lugomirski P, Guo H, Boom NK, Donovan LR, Ko DT, Tu JV. Can J Cardiol. 2013; 29(11):1382-7. Epub 2013 Jun 6.


Background — There has been significant attention to the quality of care for acute myocardial infarction (MI). However, little is known about the quality of preventive care before a patient’s first MI.

Methods — The authors conducted a retrospective, cohort analysis of 5688 patients admitted with their first MI to 96 acute care hospitals in Ontario, Canada, from April 2004 to March 2005 using the Enhanced Feedback for Effective Cardiac Treatment clinical study database. The authors calculated rates of screening for diabetes and hyperlipidemia according to guidelines using linkages to the Ontario Health Insurance Plan database. Screening rates were stratified by age, sex, socioeconomic status, and number of primary care visits in the past 5 years.

Results — Among the 5,688 eligible patients, 27.1 per cent did not receive serum cholesterol screening in the 5 years preceding their MI and 27.5 pre cent of patients did not receive a fasting blood glucose or glucose tolerance test in the 3 years before their MI. Women were more likely to be screened than men. Screening rates generally increased with age.

Conclusions — A significant number of patients admitted with their first MI were not screened for important modifiable risk factors. Opportunities for the prevention of coronary disease are being missed. More emphasis is needed on identifying risk factors before the development of acute coronary disease.

Keywords: Diabetes Coronary disease/Myocardial infarction Screening and prevention

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