title: One-year costs in patients with a history of or at risk for atherothrombosis in the United States.
abstract: BACKGROUND
  Atherothrombosis is the underlying cause of cardiovascular, cerebrovascular, and peripheral arterial disease and is the leading cause of death in the industrialized world. The objectives of the present study are (1) to examine the annual costs associated with vascular events and interventions that require hospitalization, as well as long-term medication use for the management of associated risk factors, in a US population of outpatients with multiple atherothrombotic risk factors or a history of symptomatic disease and (2) to compare costs across patient subgroups defined according to specific arterial bed(s) affected and the number of affected arterial beds.
  
  
  RESULTS
  The international REduction of Atherothrombosis for Continued Health (REACH) Registry enrolled outpatients > or =45 years of age who had established coronary artery, cerebrovascular, or peripheral artery disease or > or =3 atherothrombotic risk factors. Data on risk factors, associated medications, and vascular hospitalizations and interventions were collected. Of the total 68 236-patient REACH cohort, 25 763 were enrolled from US sites. Complete 1-year data were available for 23 974 (93%) of the US patients. Annualized medication costs ranged from $2401 to $3481. Mean annual hospitalization costs per patient were $1344, $2864, $4824, and $8155 for patients with 0 (n=6145), 1 (n=14 353), 2 (n=3106), and 3 (n=370) affected arterial beds at baseline (P<0.0001 for trend). Among patients with 1 affected arterial bed, mean hospitalization costs were $2999, $2010, and $3911 for patients with coronary artery disease (n=11 063), cerebrovascular disease (n=2613), and peripheral arterial disease (n=677), respectively. Annualized medication costs ranged from $2401 to $3481.
  
  
  CONCLUSIONS
  These results reveal the high economic burden of atherothrombosis-related clinical events and procedures and the especially high economic burden associated with polyvascular disease.
authors.affiliation: Saint Luke's Mid America Heart Institute, Kansas City, MO 64111, USA. emahoney1@saint-lukes.org
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Mahoney
authors.forename: Kaijun
authors.initials: K
authors.lastname: Wang
authors.forename: David J
authors.initials: DJ
authors.lastname: Cohen
authors.forename: Alan T
authors.initials: AT
authors.lastname: Hirsch
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Alberts
authors.forename: Kim
authors.initials: K
authors.lastname: Eagle
authors.forename: Frederique
authors.initials: F
authors.lastname: Mosse
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Jackson
authors.forename: P Gabriel
authors.initials: PG
authors.lastname: Steg
authors.forename: Deepak L
authors.initials: DL
authors.lastname: Bhatt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries / Q000473:pathology; D050197:Atherosclerosis / Q000188:drug therapy / Q000191:economics* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D018670:Monitoring, Ambulatory; D004364:Pharmaceutical Preparations / Q000191:economics; D012307:Risk Factors; D013927:Thrombosis / Q000188:drug therapy / Q000191:economics* / Q000473:pathology
chemical_list: D004364:Pharmaceutical Preparations