Patients Frequently Tested for ALT and AST With Statin Initiation

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Older adults were more likely to undergo ALT and AST testing if they were dually enrolled in Medicaid.
Older adults were more likely to undergo ALT and AST testing if they were dually enrolled in Medicaid.

(HealthDay News) – Most Medicare fee-for-service beneficiaries with dyslipidemia who initiate statins undergo baseline alanine aminotransferase (ALT) and aspartate aminotransferase (AST) testing, according to a study published in The American Journal of Cardiology.

Matthew L. Maciejewski, PhD, from the Durham Veterans Affairs Medical Center in North Carolina, and colleagues examined disparities in guideline-concordant baseline laboratory testing and abnormal laboratory values in a retrospective cohort of 76 868 Medicare fee-for-service beneficiaries from 10 states. Participants had dyslipidemia and initiated a statin from July 1 to November 30, 2011.


The researchers found that baseline laboratory testing rates were 89.3% and 88.8% for ALT and AST, respectively. The likelihood of having ALT and AST testing was increased slightly for older adults if they were dually enrolled in Medicaid (relative risk: 1.01) or had multiple chronic conditions compared with none or one condition (relative risks: 1.03, 1.08, and 1.14 for 2 to 3, 4 to 5, and 6 or more conditions, respectively). Non-Hispanic blacks were less likely than non-Hispanic whites to receive baseline testing (odds ratio: 0.97). Males were less likely than female beneficiaries to receive testing (odds ratio: 0.99). Abnormal values were rarely observed.

"In conclusion, ALT and AST assessment after statin initiation was commonly done as recommended, and there were negligible disparities in testing rates for beneficiaries," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.


  1. Maciejewski ML, Mi X, Curtis LH. Frequency of disparities in laboratory testing after statin initiation in subjects ≥65 years. Am J Cardiol. 2016; doi:10.1016/j.amjcard.2016.05.019.
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