Thank you for viewing the chest pain in my registry June case scenario regarding metric 36 high-intensity statin at discharge. In this scenario, a 78-year-old male with a past medical history of chronic kidney disease, hypertension, and diabetes presented to the ED. The patient reported experiencing shortness of breath, increasing episodes of chest pressure with exertion, and leg swelling this morning. The labs were obtained and results revealed rising positive troponins. An ECG was negative for STEMI, however, ST depressions are documented. A cardiology consult was obtained and NSTEMI was diagnosed. The patient was admitted to the Progressive Coronary Care Unit and undergoes PCI the next morning. After an uneventful overnight stay, the patient was discharged on the following medications. Aspirin 81 mg daily, Plavix 75 mg daily, Coreg 3.125 mg twice a day, Lisinopril 40 mg daily, and Simvastatin 20 mg at bedtime. Question, is this patient included in the denominator for metric 36 high-intensity statin at discharge? Number one, no, or number two, yes. Please take a moment to review. The answer is no, the patient is not included in the denominator for metric 36 high-intensity statin at discharge. While the denominator includes patients with NSTEMI or pre-admit STEMI, one of the denominator exceptions removes patients greater than 75 years of age who are prescribed a moderate-intensity statin at discharge. The 78-year-old man in this scenario was prescribed Simvastatin 20 mg at discharge, which is a moderate-intensity statin. Thank you for viewing the CHEFS PAIN MI Registry Monthly Case Scenario for June 2020.

78-year-old male patient

NSTEMI

PCI

Simvastatin 20 mg

age exception criteria