{
  "abstract": "Background: After an acute coronary syndrome event, secondary prevention is critical but remains suboptimal in underserved populations.\n\nProject Rationale: Structural barriers, neighborhood deprivation, and clinical inertia create an implementation gap in lipid management, disproportionately affecting vulnerable patients.\n\nProject Summary: LIICA (Lankenau Initiative to Improve Cardiovascular Access) is a multidisciplinary quality improvement program using the Area Deprivation Index to identify high-risk patients and enroll them in a coordinated pathway led by an advanced practice provider, interventional cardiologist, nurse navigator, community health worker (CHW), and pharmacists. The primary outcome was low-density lipoprotein cholesterol management; secondary outcomes included hemoglobin A1c, Duke Activity Status Index, blood pressure, sleep, anxiety, weight, body mass index, social needs resources, and hospital use. In this pilot cohort at 1 year, achievement of low-density lipoprotein cholesterol <55 mg/dL increased from 6.1% to 58.2%, mean hemoglobin A1c fell from 7.1% to 6.4%, Duke Activity Status Index and anxiety improved, and there were 0% second acute coronary syndrome events. Weight, body mass index, sleep, and blood pressure remained stable. CHWs provided substantial resources.\n\nTake-Home Message: A multidisciplinary, CHW-led navigation model closes the lipid management implementation gap in high-deprivation populations, converting guideline targets into real-world outcomes.",
  "abstract_shown": true,
  "affiliations": [
    "Main Line Health Lankenau Institute for Medical Research, Wynnewood, Pennsylvania, USA",
    "Main Line Health Lankenau Heart Group, Wynnewood, Pennsylvania, USA",
    "Main Line Health, Wynnewood, Pennsylvania, USA"
  ],
  "article_type": "case report",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Stephanie Kjelstrom"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Mara Caroline"
    },
    {
      "affs": [
        1
      ],
      "name": "Amanda McClendon"
    },
    {
      "affs": [
        2
      ],
      "name": "Melanie DeCecco"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "William Gray"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5dyfsax147bj3.bib",
  "cited_by": 0,
  "doi": "10.1016/j.jaccas.2026.110335",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13728408/",
  "id": "5dyfsax147bj3",
  "issns": [
    "2666-0849"
  ],
  "landing_url": "https://doi.org/10.1016/j.jaccas.2026.110335",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Health Promotion and Preventive Cardiology"
    ],
    [
      "heading",
      "Quality Improvement Projects"
    ],
    [
      "openalex",
      "2705|Lipoproteins and Cardiovascular Health"
    ]
  ],
  "openalex": "W7213418398",
  "pdf_url": null,
  "pmcid": "PMC13728408",
  "pmid": "42752019",
  "published": "2026-09-16",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/5dyfsax147bj3.ris",
  "sources": [
    {
      "first_seen": "2026-11-07T12:21:25Z",
      "native_id": "PMC13728408",
      "source": "pmc",
      "url": "https://doi.org/10.1016/j.jaccas.2026.110335"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Lipoproteins and Cardiovascular Health",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Closing Care Gaps After Acute Coronary Syndrome",
  "title_text": "Closing Care Gaps After Acute Coronary Syndrome",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:21:25Z",
  "url": "https://research.draconitic.com/paper/5dyfsax147bj3",
  "venue": "JACC Case Reports",
  "versions": []
}