Impact of new cardiovascular events on quality of life and hospital costs in people with cardiovascular disease in the United Kingdom and United States
<p><b>Background</b></p> Despite optimized risk factor control, people with prior cardiovascular disease remain at high cardiovascular disease risk. We assess the immediate‐ and longer‐term impacts of new vascular and nonvascular events on quality of life (QoL) and hospital c...
| Main Authors: | , , , , , , , , , |
|---|---|
| Other Authors: | |
| Format: | Journal article |
| Language: | English |
| Published: |
American Heart Association
2023
|
| _version_ | 1826311928542134272 |
|---|---|
| author | Lui, JNM Williams, C Keng, MJ Hopewell, JC Sammons, E Chen, F Gray, A Bowman, L Landray, MJ Mihaylova, B |
| author2 | REVEAL Collaborative Group |
| author_facet | REVEAL Collaborative Group Lui, JNM Williams, C Keng, MJ Hopewell, JC Sammons, E Chen, F Gray, A Bowman, L Landray, MJ Mihaylova, B |
| author_sort | Lui, JNM |
| collection | OXFORD |
| description | <p><b>Background</b></p>
Despite optimized risk factor control, people with prior cardiovascular disease remain at high cardiovascular disease risk. We assess the immediate‐ and longer‐term impacts of new vascular and nonvascular events on quality of life (QoL) and hospital costs among participants in the REVEAL (Randomized Evaluation of the Effects of Anacetrapib Through Lipid Modification) trial in secondary prevention.
<p><b>Methods and Results</b></p>
Data on demographic and clinical characteristics, health‐related quality of life (QoL: EuroQoL 5‐Dimension‐5‐Level), adverse events, and hospital admissions during the 4‐year follow‐up of the 21 820 participants recruited in Europe and North America informed assessments of the impacts of new adverse events on QoL and hospital costs from the UK and US health systems' perspectives using generalized linear regression models. Reductions in QoL were estimated in the years of event occurrence for nonhemorrhagic stroke (−0.067 [United Kingdom], −0.069 [US]), heart failure admission (−0.072 [United Kingdom], −0.103 [US]), incident cancer (−0.064 [United Kingdom], −0.068 [US]), and noncoronary revascularization (−0.071 [United Kingdom], −0.061 [US]), as well as in subsequent years following these events. Myocardial infarction and coronary revascularization (CRV) procedures were not found to affect QoL. All adverse events were associated with additional hospital costs in the years of events and in subsequent years, with the highest additional costs in the years of noncoronary revascularization (£5830 [United Kingdom], US dollars 14 133 [US Medicare]), of myocardial infarction with urgent CRV procedure (£5614, US dollars 24722), and of urgent/nonurgent CRV procedure without myocardial infarction (£4674/£4651 and US dollars 15 251/US dollars 17 539).
<p><b>Conclusions</b></p>
Stroke, heart failure, and noncoronary revascularization procedures substantially reduce QoL, and all cardiovascular disease events increase hospital costs. These estimates are useful in informing cost‐effectiveness of interventions to reduce cardiovascular disease risk in secondary prevention.
<p><b>Registration</b></p>
URL: https://www.clinicaltrials.gov; Unique identifier: NCT01252953; https://www.Isrctn.com. Unique identifier: ISRCTN48678192; https://www.clinicaltrialsregister.eu. Unique identifier: 2010‐023467‐18. |
| first_indexed | 2024-03-07T08:18:32Z |
| format | Journal article |
| id | oxford-uuid:51c66b67-71c6-489c-9b83-80598d7a3996 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T08:18:32Z |
| publishDate | 2023 |
| publisher | American Heart Association |
| record_format | dspace |
| spelling | oxford-uuid:51c66b67-71c6-489c-9b83-80598d7a39962024-01-19T08:55:58ZImpact of new cardiovascular events on quality of life and hospital costs in people with cardiovascular disease in the United Kingdom and United StatesJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:51c66b67-71c6-489c-9b83-80598d7a3996EnglishSymplectic ElementsAmerican Heart Association2023Lui, JNMWilliams, CKeng, MJHopewell, JCSammons, EChen, FGray, ABowman, LLandray, MJMihaylova, BREVEAL Collaborative Group<p><b>Background</b></p> Despite optimized risk factor control, people with prior cardiovascular disease remain at high cardiovascular disease risk. We assess the immediate‐ and longer‐term impacts of new vascular and nonvascular events on quality of life (QoL) and hospital costs among participants in the REVEAL (Randomized Evaluation of the Effects of Anacetrapib Through Lipid Modification) trial in secondary prevention. <p><b>Methods and Results</b></p> Data on demographic and clinical characteristics, health‐related quality of life (QoL: EuroQoL 5‐Dimension‐5‐Level), adverse events, and hospital admissions during the 4‐year follow‐up of the 21 820 participants recruited in Europe and North America informed assessments of the impacts of new adverse events on QoL and hospital costs from the UK and US health systems' perspectives using generalized linear regression models. Reductions in QoL were estimated in the years of event occurrence for nonhemorrhagic stroke (−0.067 [United Kingdom], −0.069 [US]), heart failure admission (−0.072 [United Kingdom], −0.103 [US]), incident cancer (−0.064 [United Kingdom], −0.068 [US]), and noncoronary revascularization (−0.071 [United Kingdom], −0.061 [US]), as well as in subsequent years following these events. Myocardial infarction and coronary revascularization (CRV) procedures were not found to affect QoL. All adverse events were associated with additional hospital costs in the years of events and in subsequent years, with the highest additional costs in the years of noncoronary revascularization (£5830 [United Kingdom], US dollars 14 133 [US Medicare]), of myocardial infarction with urgent CRV procedure (£5614, US dollars 24722), and of urgent/nonurgent CRV procedure without myocardial infarction (£4674/£4651 and US dollars 15 251/US dollars 17 539). <p><b>Conclusions</b></p> Stroke, heart failure, and noncoronary revascularization procedures substantially reduce QoL, and all cardiovascular disease events increase hospital costs. These estimates are useful in informing cost‐effectiveness of interventions to reduce cardiovascular disease risk in secondary prevention. <p><b>Registration</b></p> URL: https://www.clinicaltrials.gov; Unique identifier: NCT01252953; https://www.Isrctn.com. Unique identifier: ISRCTN48678192; https://www.clinicaltrialsregister.eu. Unique identifier: 2010‐023467‐18. |
| spellingShingle | Lui, JNM Williams, C Keng, MJ Hopewell, JC Sammons, E Chen, F Gray, A Bowman, L Landray, MJ Mihaylova, B Impact of new cardiovascular events on quality of life and hospital costs in people with cardiovascular disease in the United Kingdom and United States |
| title | Impact of new cardiovascular events on quality of life and hospital costs in people with cardiovascular disease in the United Kingdom and United States |
| title_full | Impact of new cardiovascular events on quality of life and hospital costs in people with cardiovascular disease in the United Kingdom and United States |
| title_fullStr | Impact of new cardiovascular events on quality of life and hospital costs in people with cardiovascular disease in the United Kingdom and United States |
| title_full_unstemmed | Impact of new cardiovascular events on quality of life and hospital costs in people with cardiovascular disease in the United Kingdom and United States |
| title_short | Impact of new cardiovascular events on quality of life and hospital costs in people with cardiovascular disease in the United Kingdom and United States |
| title_sort | impact of new cardiovascular events on quality of life and hospital costs in people with cardiovascular disease in the united kingdom and united states |
| work_keys_str_mv | AT luijnm impactofnewcardiovasculareventsonqualityoflifeandhospitalcostsinpeoplewithcardiovasculardiseaseintheunitedkingdomandunitedstates AT williamsc impactofnewcardiovasculareventsonqualityoflifeandhospitalcostsinpeoplewithcardiovasculardiseaseintheunitedkingdomandunitedstates AT kengmj impactofnewcardiovasculareventsonqualityoflifeandhospitalcostsinpeoplewithcardiovasculardiseaseintheunitedkingdomandunitedstates AT hopewelljc impactofnewcardiovasculareventsonqualityoflifeandhospitalcostsinpeoplewithcardiovasculardiseaseintheunitedkingdomandunitedstates AT sammonse impactofnewcardiovasculareventsonqualityoflifeandhospitalcostsinpeoplewithcardiovasculardiseaseintheunitedkingdomandunitedstates AT chenf impactofnewcardiovasculareventsonqualityoflifeandhospitalcostsinpeoplewithcardiovasculardiseaseintheunitedkingdomandunitedstates AT graya impactofnewcardiovasculareventsonqualityoflifeandhospitalcostsinpeoplewithcardiovasculardiseaseintheunitedkingdomandunitedstates AT bowmanl impactofnewcardiovasculareventsonqualityoflifeandhospitalcostsinpeoplewithcardiovasculardiseaseintheunitedkingdomandunitedstates AT landraymj impactofnewcardiovasculareventsonqualityoflifeandhospitalcostsinpeoplewithcardiovasculardiseaseintheunitedkingdomandunitedstates AT mihaylovab impactofnewcardiovasculareventsonqualityoflifeandhospitalcostsinpeoplewithcardiovasculardiseaseintheunitedkingdomandunitedstates |