High-Risk Atherosclerotic Cardiovascular Disease in a Real-World Employed Japanese Population: Prevalence, Cardiovascular Event Rates, and Costs
High-Risk Atherosclerotic Cardiovascular Disease in a Real-World Employed Japanese Population: Prevalence, Cardiovascular Event Rates, and Costs
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DOI：
10.5551/jat.28852
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发表时间：
2015-01-01
影响因子：
4.4
通讯作者：
Murakami, Masahiro
中科院分区：
文献类型：
--
作者：
Davis, Keith L.;Meyers, Juliana;Murakami, Masahiro
目的：评估高危动脉粥样硬化性心血管疾病的患病率（ASCVD，定义为急性冠状动脉综合征[hACS]、脑血管粥样硬化性疾病[CeVAD]、外周动脉疾病[PAD]或冠状动脉疾病伴糖尿病[CADD]病史）和相关费用及心血管（CV）事件。使用日本医学数据中心（JMDC）数据库（2006-2011）进行回顾性分析。根据CeVAD、PAD、CADD和hACS的诊断估计ASCVD患病率（ACS索赔在2008年1月1日至2009年12月31日期间首次/指数ASCVD索赔之前>30- = 12个月和之后>= 24个月），并根据成本（以2012年美元计）和事件进行分析。总共有8，112例患者符合成本和CV事件分析的入选标准。在这些患者中，4.0%的患者在ASCVD诊断后一年内发生过任何事件（心肌梗死、中风、冠状动脉血运重建、因不稳定型心绞痛住院），第2年这一比例下降至2.2%。hACS患者的第一年事件发生率最高（22%）。对于所有ASCVD患者，第1年每例患者的平均[SD]全因成本为7，031美元[14，359美元]。外推到整个就业人口，第一年的总成本估计为$8.2 billion.Conclusions：ASCVD在日本并不罕见，即使在一个相对年轻的就业人口。此外，ASCVD在日本就业人群中的第一年直接费用负担很高。这些数据可能会为未来新ASCVD治疗的经济评估提供信息。
Aim: To assess the prevalence of high-risk atherosclerotic cardiovascular disease (ASCVD, defined as history of acute coronary syndrome [hACS], cerebrovascular atherosclerotic disease [CeVAD], peripheral artery disease [PAD], or coronary artery disease w/diabetes [CADD]) and associated costs and cardiovascular (CV) events in Japan.Methods: A retrospective analysis was conducted using the Japan Medical Data Center (JMDC) database (2006-2011). ASCVD prevalence was estimated on the basis of diagnoses for CeVAD, PAD, CADD, and hACS (ACS claim >30- = 12 months before and >= 24 months after first/index ASCVD claim during 1/1/2008-12/31/2009 were analyzed on the basis of costs (in 2012 US dollars) and events.Results: ASCVD prevalence was 1,869/100,000 population. In total, 8,112 patients met inclusion criteria for the cost and CV event analyses. Among these patients, 4.0% experienced any event (myocardial infarction, stroke, coronary revascularization, hospitalization for unstable angina) in the year after ASCVD diagnosis, which decreased to 2.2% in year 2. First-year event rates were highest (22%) in patients with hACS. Mean [SD] all-cause costs per patient in year 1 were $7,031 [$14,359] for all patients with ASCVD combined. Extrapolated to the entire employed population, total first-year costs were estimated at $8.2 billion.Conclusions: ASCVD is not rare in Japan, even within a relatively young population of employed persons. Further, the total direct first-year cost burden of ASCVD in the employed Japanese population is high. These data may inform future economic assessments of new ASCVD treatments.