title: Burden of First and Recurrent Cardiovascular Events Among Patients With Hyperlipidemia.
abstract: BACKGROUND
  Acute cardiovascular (CV) events have been evaluated in patients with specific comorbidities but have not focused on patients with hyperlipidemia or on the their long-term costs.
  
  
  OBJECTIVE
  To evaluate incidence of CV events, costs, and resource utilization among patients with hyperlipidemia and baseline risk of CV disease (CVD).
  
  
  METHODS
  Patients (age 18 to 64 years) diagnosed with hyperlipidemia or using lipid-modifying medications were identified from administrative claims. Patients were categorized into 3 cohorts based on pre-index clinical characteristics-secondary prevention (SP; history of CV event, n = 15 613); high risk (HR; CVD, n = 47 600); and primary prevention (PP; no CV event history or CVD, n = 60 637)-and followed up to 2 years after the CV event.
  
  
  RESULTS
  During follow-up, ≥1 new CV event occurred in 43.0% of the SP cohort, 33.9% of HR, and 20.9% of PP; and ≥3 new events occurred in 19.8% of the SP cohort, 12.9% of HR, and 5.5% of PP. Incremental total costs were $19 320 for SP, $20 003 for HR, and $17 650 for PP. Compared with patients with only 1 CV event, the mean 2-year cost was 30% higher in patients with 2 CV events and 48% higher in patients with 3 CV events. Only 50% of HR patients (with or without CV events) received statins.
  
  
  CONCLUSIONS
  Patients with recurrent CV events had higher total health care costs during 24-month follow-up for each type of CV event. Total health care costs among patients with a CV event were higher for the initial as well as subsequent events. Statins and lipid-modifying medications were significantly underutilized in all cohorts, despite the presence of CVD.
authors.affiliation: HealthCore, Inc., Wilmington, Delaware.
authors.forename: Rajeshwari S
authors.initials: RS
authors.lastname: Punekar
authors.affiliation: Strategic Healthcare Solutions, LLC, Baltimore, Maryland.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Fox
authors.affiliation: Amgen, Inc., Thousand Oaks, California.
authors.forename: Akshara
authors.initials: A
authors.lastname: Richhariya
authors.affiliation: HealthCore, Inc., Wilmington, Delaware.
authors.forename: Maxine D
authors.initials: MD
authors.lastname: Fisher
authors.affiliation: HealthCore, Inc., Wilmington, Delaware.
authors.forename: Mark
authors.initials: M
authors.lastname: Cziraky
authors.affiliation: Amgen, Inc., Thousand Oaks, California.
authors.forename: Shravanthi R
authors.initials: SR
authors.lastname: Gandra
authors.affiliation: CGH Medical Center, Sterling, Illinois.|Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: Peter P
authors.initials: PP
authors.lastname: Toth
mesh_terms: D000293:Adolescent; D000328:Adult; D002318:Cardiovascular Diseases / Q000191:economics / Q000453:epidemiology / Q000209:etiology*; D015331:Cohort Studies; D017281:Cost of Illness; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006295:Health Resources / Q000706:statistics & numerical data*; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications* / Q000191:economics; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D055815:Young Adult