Mitch hayes ascvd risk assessment powerpoint

1. CVD Risk
Assessment for 20
Patients and Grant
Proposal
Mitch Hayes
VMS 3
August 28, 2016

2. Case
 PMH
 HLD
 T2DM
 HTN
 Gout
 SH: single, one child, smokes 1/2 ppd,
drinks occasionally, drives forklift
 FH: father died at 49 of CAD

3. Case continued
 PE:
 P 85, BP 132/74, RR 18, BMI 29.6
 CV: no rubs, murmurs, gallops
 Resp: CTAB
 Abd: nontender, NABS
 Labs:
 Total chol 194, HDL 52
 Meds:
 multiple

4. ASCVD Risk Calculation
 2015: age 56
 Total chol 194, HDL 52 (with statin
therapy)
 SBP 122 from annual clinic visit
 +HTN tx, +DM, current smoker (1/2ppd for
>32 years)
 10 year risk for coronary death, nonfatal MI,
and all stroke:
23.8%

5. Deaths due to CVD have
decreased in recent years

6. But CVD continues to be #1
cause of death in USA

7. Many community resources
available for improvement

8. ASCVD Risk calculation

9. Aggregate data
0
10
20
30
40
50
60
40 45 50 55 60 65 70 75 80 85
ASCVD10yearrisk
Age
ASCVD 10 year risk by age
13.8%

10. Grant Proposal: Smoking
Cessation as a Target of Risk
Reduction
 Smoking cessation
 Why?
 Huge impact on CVD risk
 Huge impact on other risks and overall
health
 Rates of smoking have decreased
significantly in recent decades
 Increased awareness of smoking as a
health risk

11. Planned intervention
 PCPs will screen patients who smoke and
may be interested in quitting
 Pay health coach $5000 to spend 15
minutes with patients who smoke to develop
plans to quit smoking
 Follow up in 1 year to track success rate

12. Metric to determine
improvement
 Track patient-reported success rate of
smoking cessation at 1 year
 Continue to provide support to patients
 Continue to track smoking use amongst
patients

13. Time course
 Review annual physical notes for update on
smoking cessation progress at 1, 2, and 5
years

14. Defense
 Smoking continues to be a risk factor for
many diseases including CVD
 Smoking cessation interventions can make a
huge impact on a patient’s overall health
 Improvement in health outcomes can lead to
huge cost savings
 $5000 pales in comparison to even one
hospitalization due to nonfatal MI or stroke

15. Thank you