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Background

The 2018 AHA/ACC cholesterol guideline considers adults with a history of≥ 2 atherosclerotic cardiovascular disease (ASCVD) events as being at very high risk for future events. We compared the risk for ASCVD events following a myocardial infarction (MI) among patients with a prior history of ASCVD, chronic kidney disease (CKD) and diabetes mellitus (DM).

Methods

We studied adults≥ 66 years old with Medicare health insurance who had an MI on or after January 1, 2014. Patients were grouped into 8 categories based on the presence of a prior history of ASCVD, DM and/or CKD and followed until December 31, 2017 for ASCVD events. ASCVD was defined as an MI, coronary revascularization, stroke, or peripheral artery disease event.

Results

Among 380,071 patients discharged from the hospital following an MI, 20.8%, 9.8% and 3.4% had a prior history of ASCVD only, DM only and CKD only …