Abstract 15187: High Triglycerides Increase Cardiovascular Events, Medical Costs, and Resource Utilization in a Real-World Analysis of Statin-Treated Patients With High Cardiovascular Risk and Well-Controlled Low-Density Lipoprotein Cholesterol
Introduction: The AHA recognizes high TG as an important CV risk factor. The landmark REDUCE-IT study is prospectively evaluating the effects of adding a high-dose omega-3 fatty acid to statin therapy on long-term CV events in high-risk patients with high TG.
Objective: Analyze real-world data on CV outcomes, health care costs, and resource utilization in a patient population similar to REDUCE-IT.
Methods: This retrospective administrative claims analysis of the Optum Research Database included patients aged ≥45 years with diabetes and/or ASCVD who had a statin prescription filled in 2010, had continuous medical/pharmacy coverage (index date in 2010), and were followed for ≥6 months (or less if due to death) up to March 2016. Patients with TG 200-499 mg/dL and a propensity-matched comparator cohort with TG <150 mg/dL and HDL-C >40 mg/dL were included in this analysis. Hazard ratios and cost ratios were calculated from multivariate analyses.
Results: In the high-TG cohort (n=10,990) vs matched comparator cohort (n=10,990), respectively, mean (SD) age was 61.7 (9.6) vs 62.2 (9.9) years and mean follow-up was 41.3 (23.8) vs 42.1 (23.9) months. Both cohorts were 49.4% female. Probability of occurrence of the composite of major CV events, as well as nonfatal MI, nonfatal stroke, and coronary revascularization, were significantly greater in the high TG cohort than the comparator cohort (all P<0.001), as was CV-related death (P=0.021); no significant difference was found for unstable angina (Kaplan-Meier analysis). Multivariate analyses of major CV events, average monthly total health care costs, and rate of occurrence of an inpatient hospital stay are shown in the Table.
Conclusions: Patients with high TG similar to those in REDUCE-IT had worse CV and health economic outcomes than matched patients with well-managed TG, including higher risk for nonfatal MI and stroke, need for coronary revascularization, and CV mortality. Funding: Amarin Pharma Inc.
Author Disclosures: P.P. Toth: Speakers Bureau; Significant; Amarin Pharma Inc., Amgen, Kowa, Regeneron, Sanofi. Consultant/Advisory Board; Modest; Amgen, Gemphire, Merck, Sanofi. Consultant/Advisory Board; Significant; Amarin Pharma Inc., Kowa, Regeneron. C. Granowitz: Employment; Significant; Amarin Pharma Inc.. Ownership Interest; Significant; Amarin Pharma Inc. M. Hull: Employment; Significant; Optum. D. Liassou: Employment; Significant; Optum. Other; Significant; Optum. A. Anderson: Employment; Modest; Optum. Other; Modest; Optum. S. Philip: Employment; Significant; Amarin Pharma Inc.. Ownership Interest; Significant; Amarin Pharma Inc..
- © 2017 by American Heart Association, Inc.