title: Antithrombotic Therapy and Direct Medical Costs in Patients with Acute Coronary Syndrome in Shanghai, China.
abstract: BACKGROUND
  Acute coronary syndrome (ACS) is a leading cause of morbidity and mortality worldwide.
  
  
  OBJECTIVE
  To describe patient profile, treatment patterns, and disease burden for patients with ACS.
  
  
  METHODS
  A retrospective descriptive cohort study was conducted. Data were obtained from electronic medical records from seven Shanghai medical centers. Patients with at least one primary diagnosis of ACS from 2006 to 2012 were included. Patient ACS-related antithrombotic medication use, laboratory tests, key comorbidities, health care utilization, and direct medical costs were examined. Log-linear regression was conducted to explore factors associated with total direct medical costs.
  
  
  RESULTS
  The mean age for the 6601 patients included was 69.7 ± 12.5 years, and most of the patients (73%) were men. Comorbidities included diabetes (18.2%), hypertension (21.2%), and hyperlipidemia (8.6%). Out of these, 6466 (98%) patients had been hospitalized for ACS with an average length of stay of 14.0 ± 16.4 days per hospitalization. A total of 914 (13.8%) patients had emergency room visits. Of these, 93.5% received any antithrombotic therapy, including antiplatelet agents (92.7%) and anticoagulants (20.8%). ACS-related direct medical costs (in yuan renminbi [¥]) were ¥18,421 ± ¥24,741 per hospitalization, including costs for medications (¥6,776) and laboratory tests (¥1,355), and ¥2,894 ± ¥7,060 per outpatient visit, including costs for medications (¥620) and laboratory tests (¥464). The higher direct medical cost was associated significantly (P < 0.05) with age, being male, antiplatelet and anticoagulant use, and several comorbid disease states (diabetes, hyperlipidemia, hypertension, and chronic kidney disease).
  
  
  CONCLUSIONS
  Antithrombotic therapeutic treatments were commonly used among patients with ACS in Shanghai, China. Higher treatment costs for patients with ACS in Shanghai, China, involved their antithrombotic medication use and key comorbidities.
authors.affiliation: Pharmacoepidemiology and Pharmacoeconomics, College of Pharmacy, University of Cincinnati Academic Health Center, Cincinnati, OH, USA. Electronic address: jeff.guo@uc.edu.
authors.forename: Jeff J
authors.initials: JJ
authors.lastname: Guo
authors.affiliation: Lilly Suzhou Pharmaceutical Co., Ltd., Shanghai, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Adverse Drug Reaction Reporting Center, Shanghai Food and Drug Administration, Shanghai, China.
authors.forename: Wenmin
authors.initials: W
authors.lastname: Du
authors.affiliation: Pharmacoepidemiology and Pharmacoeconomics, College of Pharmacy, University of Cincinnati Academic Health Center, Cincinnati, OH, USA.
authors.forename: Hongying
authors.initials: H
authors.lastname: Peng
authors.affiliation: Pharmacoepidemiology and Pharmacoeconomics, College of Pharmacy, University of Cincinnati Academic Health Center, Cincinnati, OH, USA.
authors.forename: Rui
authors.initials: R
authors.lastname: Wang
authors.affiliation: Pharmacoepidemiology and Pharmacoeconomics, College of Pharmacy, University of Cincinnati Academic Health Center, Cincinnati, OH, USA.
authors.forename: Ying
authors.initials: Y
authors.lastname: Xia
authors.affiliation: Lilly Suzhou Pharmaceutical Co., Ltd., Shanghai, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Xin
authors.affiliation: Pharmacoepidemiology and Pharmacoeconomics, College of Pharmacy, University of Cincinnati Academic Health Center, Cincinnati, OH, USA.
authors.forename: Patricia R
authors.initials: PR
authors.lastname: Wigle
authors.affiliation: Global Patient Outcomes and Real World Evidence, Eli Lilly & Company, Indianapolis, IN, USA; Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada.
authors.forename: Emmanuel A
authors.initials: EA
authors.lastname: Papadimitropoulos
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy* / Q000191:economics; D000368:Aged; D000369:Aged, 80 and over; D002681:China; D003365:Costs and Cost Analysis; D005260:Female; D005343:Fibrinolytic Agents / Q000191:economics* / Q000627:therapeutic use; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D005343:Fibrinolytic Agents
keywords: acute coronary syndrome; antithrombotic therapy; medical cost