Electronic Health Record Alerts to Improve Lipid Lowering After a Recent Myocardial Infarction

Journal of the American Heart Association, Volume 15, Issue 12 , June 16, 2026. BackgroundThis observational, quality initiative evaluated the impact of changing from a passive (dismissible) to an active (nondismissible without action) electronic health record alert on guideline‐recommended lipid‐lowering therapy (LLT) prescriptions in patients with recent myocardial infarction at risk for secondary events.MethodsWe sequentially recruited a retrospective passive‐alert (February 2018–July 2019; n=733) and a prospective active‐alert (August 2020–January 2022; n=587) cohort of patients who triggered an alert to intensify LLT or order a low‐density lipoprotein‐cholesterol (LDL‐C) test if they had a recent myocardial infarction (within 12 months) and elevated (≥70 mg/dL) or missing LDL‐C.

Prescribed LLTs and cumulative percentages of patients with missing or LDL‐C <70 and <55 mg/dL were assessed in 6‐month periods up to 24 months. Reasons for not intensifying LLTs were recorded with the active alert.ResultsDuring 24 months, statin and high‐intensity statin use increased from 59% to 87% and from 39% to 69%, respectively, in the passive‐alert cohort.