2254. Adherence to Cardiovascular Disease Risk Management Guidelines Amongst HIV Providers at an Academic HIV Clinic

BACKGROUND: Cardiovascular disease (CVD) among HIV-infected individuals contributes significantly to morbidity and mortality, accounting for one third of non-AIDS defining illness and 11% of deaths. Compared with the general population, HIV-infected individuals are known to have elevated risk for CVD with chronic infection, regardless of HIV RNA levels and studies suggests that clinicians are not appropriately managing ASCVD risk in HIV-infected patients. METHODS: This retrospective cross-sectional study evaluated provider adherence to American College of Cardiology and American Heart Association guidelines for cardiovascular risk assessment and management, as well, as risk factors associated with inadequate management. Data were extracted from electronic medical records at a single institution in Detroit, Michigan. Criteria for inclusion were >39 years of age, HIV infected, and clinic visit during June 2017. RESULTS: Of 209 patients evaluated at the infectious disease clinic, 175 patients (84%) qualified per guidelines for statin therapy. Only 44% of these patients are taking a statin. Statin users were older and more likely to be nonsmokers than nonusers (P = 0.0022). Amongst patients on statin therapy, 77% receive appropriate intensity therapy. These patients tend to be older (P = 0.0212) and receive a high intensity regimen (P < 0.0001). CD4 count and viral loud were not associated with statin eligibility or appropriate intensity therapy. CONCLUSION: Despite high rates of patients qualifying for statin therapy, a majority of patients do not receive statins to manage cardiovascular disease risk. Of note, patients at elevated risk for cardiovascular disease due to smoking are less likely to receive therapy. However, amongst patients receiving statin therapy, treatment tends to be appropriate, especially with older patients on high intensity therapy. DISCLOSURES: J. Veltman, Janssen: Speaker’s Bureau, Speaker honorarium.