Coronary care physician 1994-2000 adherence to 1993 National Cholesterol Education Program diet and lipid recommendations

The 1993 NCEP recommended phase 2 diets and less than or equal to 100 mg/dl LDL goals for all atherosclerotic patients. We reviewed Washington, DC phy sician 1994-2000 use of these recommendations for coronary care unit (CCU) patients. Questionnaires, chart reviews and interviews of cardiologists, residents an d dietitians showed > 80% of CCU physicians ignored NCEP dietary recommenda tions. NCEP 1 diets were ordered for similar to 80% of patients. NCEP 2, AH A 3 or vegetarian diets were used for < 20%. Statins were reported for simi lar to 25% of patients in 1994-95 but were on < 20% of charts in 1996-7. Th is increased to similar to 58% by 2000. NCEP 2 diets lower cholesterol similar to5%, rarely reaching LDL goals, and < 20% of CHD patients on anti-lipid therapy were at NCEP IDL goals by 1999 . With 1-year post-myocardial infarction 34% mortality and 53% readmission rates, we need early and much more aggressive anti-lipid diets and drugs in treating these patients.