EMERALD (Emergency Medicine Cardiovascular Risk Assessment for Lipid Disorders)

Wake Forest University Health Sciences22 enrolled

Overview

The EMERALD intervention involves 1) ordering an Emergency Department (ED) lipid panel, 2) calculating 10-year Atherosclerotic cardiovascular disease (ASCVD) risk using the Pooled Cohort Equations, 3) prescribing a moderate- or high-intensity statin if applicable, and 4) referring patients to outpatient care (primary care, preventive cardiology, or general cardiology, depending on risk level).

EMERALD (Emergency Medicine Cardiovascular Risk Assessment for Lipid Disorders) is a pilot study seeking to determine the feasibility of initiating medical therapy for hyperlipidemia (HLD) in the Emergency Department (ED) and will collect data essential to inform a future randomized controlled trial comparing ED HLD treatment to usual care. HLD is a key cardiovascular disease (CVD) risk factor that is causally associated with atherosclerotic cardiovascular disease (ASCVD), the leading cause of US mortality and morbidity.

Study Type

INTERVENTIONAL

Allocation

Purpose

PREVENTION

Masking

NONE

Enrollment

Conditions

Lipid Disorder

Interventions

moderate- or high-intensity statin/ rosuvastatinDRUG

moderate- or high-intensity statin (either rosuvastatin 10mg daily or rosuvastatin 40 mg daily)

Eligibility

Sex: ALLMin age: 40 YearsMax age: 75 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Emergency Department (ED) patients with chest pain * 40-75 years old * a low-density lipoprotein cholesterol (LDL-C) ≥70 mg/dL on an ED lipid panel or have known diabetes or Atherosclerotic Cardiovascular Disease (ASCVD) Exclusion Criteria: * Subject unwilling to take study medication * Pregnancy or breastfeeding * Inability to take study medication or, in the opinion of the Investigators/subject's doctors unsuitable for study participation * ST-Segment Elevation Myocardial Infarction (STEMI) Activation * ST-Segment Depression \>1 mm * On a Lipid Lowering Agent (Statin, PCSK9 Inhibitor, Bempedoic Acid, Ezetimibe, Inclisiran) * Unstable Vitals (Blood Pressure (BP) \<90, Heart Rate (HR) \>120 or \<50, O2 sat \<90%) * Statin Intolerance * High-sensitivity Troponin I ≥100 ng/L * End-Stage Renal Disease (ESRD) and/or glomerular filtration rate (GFR) \<30 mL/min/1.73 m2 * Liver Cirrhosis * Hospitalization * Life Expectancy \<1 Year * Transfer from Another Hospital * Prisoner * Non-English Speaking

Locations (1)

Wake Forest University Health Sciences

Winston-Salem, North Carolina, United States

Outcomes

Primary Outcomes

Low-density Lipoprotein Cholesterol (LDL-C) Levels at Baseline and Day 30

A lipid panel is a common blood test that healthcare providers use to monitor and screen for risk of cardiovascular disease. The panel includes three measurements of your cholesterol levels and a measurement of your triglycerides.

Time frame: Baseline and Day 30

Data from ClinicalTrials.gov

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