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Outcomes and excess costs among patients with cardiovascular disease

Research output: Contribution to journalJournal article

Published
  • Zanfina Ademi
  • Danny Liew
  • Ella Zomer
  • Alexandra Gorelik
  • Bruce Hollingsworth
  • Ph. Gabriel Steg
  • Deepak L. Bhatt
  • Christopher M. Reid
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<mark>Journal publication date</mark>2013
<mark>Journal</mark>Heart, Lung and Circulation
Issue number9
Volume22
Number of pages7
Pages (from-to)724-730
Publication statusPublished
Original languageEnglish

Abstract

Objective
To report on two-year cardiovascular (CV) event rates and quantify the cost of cardiovascular disease using the Australian Reduction of Atherothrombosis for Continued Health (REACH) registry.

Methods
Prospective registry of 2873 patients with multiple risk factors (MRF), coronary artery disease (CAD), cerebrovascular disease (CerVD) and peripheral artery disease (PAD), recruited through 273 Australian general practitioners. Government reimbursement data from 2011 was used to calculate direct health care costs (pharmaceuticals, outpatient and hospitalisation costs). The main outcome of interest was two-year rates and associated excess costs of cardiovascular death, myocardial infarction, stroke, and hospitalisation for cardiovascular procedures.

Results
The two year follow-up data were available for 2856 (99.4%) patients. Incidence of any hospitalisation and cardiovascular death was highest among those with previous history of PAD at baseline 49% (n = 126), and 5.1% (n = 13). Non-fatal cardiovascular events were highest among the PAD and CAD groups (21.8% (n = 56) and 14.1% (n = 297) respectively). Those with previous history of PAD and CerVD at baseline had the highest likelihood of CV death (OR = 2.53 (95% CI: 1.58–4.08) and OR = 1.61 (1.05–2.46) respectively) in comparison to other groups. Patients with PAD had the highest likelihood of vascular interventions OR = 3.11 (95% CI: 2.09–4.63) at two years. Overall, the mean (SD) direct expenditure over two years of follow-up per person was A$7544 (A$10,758). In the adjusted model, patients with CAD and PAD incurred A$1093 (95% CI A$24 – A$2072) and A$4890 (95% CI A$3105 – A$6869) more in mean total costs compared to patients with MRF.

Conclusions
Patients with PAD had the highest likelihood of vascular interventions and CV death, and incurred high excess costs in comparison to other groups.