TEACHING HOSPITAL. J.L. Schnipper 1 , R.S. Stafford 1 ; 1 Massachusetts General Hospital, Boston, MA PURPOSE: To determine the extent to which outpatients with coronary artery disease (CAD) receive adequate secondary prevention measures, and to identify the factors that predict variations in the provision of these services. METHODS: Cross-sectional study of 3920 patients with coronary disease (ICD-9 codes 410.0 ± 414.99) who were seen in one of ten outpatient practices affiliated with Massachusetts General Hospital (MGH) during fiscal year 1997. Demographic and laboratory information were collected on all patients, and a medical record review was performed on a subset of patients to confirm CAD and to determine blood pressures, medical conditions, and medications during fiscal years 1997 and 1998 (N = 302). RESULTS: Our study showed evidence of variable short-comings among different CAD prevention strategies. 17% of patients never received a low density lipoprotein (LDL) cholesterol test during the study period, and only 19% of patients had an LDL level 100 mg/ dL. Among those with an LDL ! 130 mg/dL, 41% received no lipid-lowering medication and only 5% were on a standard maximum dose of an HMG CoA reductase inhibitor (statin). The average of the last two blood pressure readings was less than 130/85 mm Hg in 42% of patients, and 53% of patients met JNC VI guidelines for blood pressure control. Among hypertensive patients, 94% were on some type of anti-hypertensive medication. 75% of all patients were prescribed a beta-blocker during the time period, and 86% were prescribed aspirin or another antithrombotic medication.