title: Clinical and economic burden associated with cardiovascular events among patients with hyperlipidemia: a retrospective cohort study.
abstract: BACKGROUND
  Annual direct costs for cardiovascular (CV) diseases in the United States are approximately $195.6 billion, with many high-risk patients remaining at risk for major cardiovascular events (CVE). This study evaluated the direct clinical and economic burden associated with new CVE up to 3 years post-event among patients with hyperlipidemia.
  
  
  METHODS
  Hyperlipidemic patients with a primary inpatient claim for new CVE (myocardial infarction, unstable angina, ischemic stroke, transient ischemic attack, coronary artery bypass graft, percutaneous coronary intervention and heart failure) were identified using IMS LifeLink PharMetrics Plus data from January 1, 2006 through June 30, 2012. Patients were stratified by CV risk into history of CVE, modified coronary heart disease risk equivalent, moderate- and low-risk cohorts. Of the eligible patients, propensity score matched 243,640 patients with or without new CVE were included to compare healthcare resource utilization and direct costs ranging from the acute (1-month) phase through 3 years post-CVE date (follow-up period).
  
  
  RESULTS
  Myocardial infarction was the most common CVE in all the risk cohorts. During the acute phase, among patients with new CVE, the average incremental inpatient length of stay and incremental costs ranged from 4.4-6.2 days and $25,666-$30,321, respectively. Acute-phase incremental costs accounted for 61-75% of first-year costs, but incremental costs also remained high during years 2 and 3 post-CVE.
  
  
  CONCLUSIONS
  Among hyperlipidemic patients with new CVE, healthcare utilization and costs incurred were significantly higher than for those without CVE during the acute phase, and remained higher up to 3 years post-event, across all risk cohorts.
authors.affiliation: Strategic Healthcare Solutions, LLC, Monkton, MD, USA. kathyfox@gforcecable.com.|Strategic Healthcare Solutions, LLC, 133 Cottonwood Creek Lane, Aiken, SC, 29803, USA. kathyfox@gforcecable.com.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Fox
authors.affiliation: STATinMED Research, Plano, TX, USA.
authors.forename: Li
authors.initials: L
authors.lastname: Wang
authors.affiliation: Amgen Inc, Thousand Oaks, CA, USA.
authors.forename: Shravanthi R
authors.initials: SR
authors.lastname: Gandra
authors.affiliation: Amgen Inc, Thousand Oaks, CA, USA.
authors.forename: Ruben G W
authors.initials: RGW
authors.lastname: Quek
authors.affiliation: STATinMED Research, Plano, TX, USA.
authors.forename: Lu
authors.initials: L
authors.lastname: Li
authors.affiliation: Center for Innovation & Outcomes Research, Department of Surgery, Columbia University, New York, NY, USA.|MEF University, Istanbul, Turkey.
authors.forename: Onur
authors.initials: O
authors.lastname: Baser
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000789:Angina, Unstable / Q000191:economics* / Q000453:epidemiology; D016022:Case-Control Studies; D015331:Cohort Studies; D001026:Coronary Artery Bypass / Q000191:economics / Q000706:statistics & numerical data; D016208:Databases, Factual; D005260:Female; D017048:Health Care Costs; D006333:Heart Failure / Q000191:economics* / Q000453:epidemiology; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D006949:Hyperlipidemias / Q000191:economics* / Q000453:epidemiology; D002546:Ischemic Attack, Transient / Q000191:economics* / Q000453:epidemiology; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000191:economics* / Q000453:epidemiology; D009204:Myocardial Revascularization / Q000191:economics* / Q000706:statistics & numerical data; D062645:Percutaneous Coronary Intervention / Q000191:economics / Q000706:statistics & numerical data; D057216:Propensity Score; D012189:Retrospective Studies; D020521:Stroke / Q000191:economics* / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D055815:Young Adult