Affiliation:
1. University of Connecticut School of Pharmacy Storrs CT
2. Hartford Hospital Evidence‐Based Practice Center Hartford CT
3. Vicerrectorado de Investigacion Universidad San Ignacio de Loyola (USIL) Lima Peru
4. Neuroscience Institute Hartford Hospital Hartford CT
Abstract
Background
There is a paucity of contemporary data estimating the incidence of major adverse cardiovascular events (
MACE
) in patients with established atherosclerotic disease or multiple risk factors managed in routine practice. We estimated 1‐ and 4‐year incidences of
MACE
and the association between
MACE
and vascular beds affected in these patients.
Methods and Results
Using
US IBM
MarketScan data from January 1, 2013 to December 31, 2017, we identified patients ≥45 years old with established coronary artery disease, cerebrovascular disease, peripheral artery disease, or the presence of ≥3 risk factors for atherosclerosis during 2013 with a minimum of 4 years of follow‐up. We calculated 1‐ and 4‐year incidences of
MACE
(cardiovascular death or hospitalization for myocardial infarction or ischemic stroke). A Cox proportional hazards regression model adjusted for age and sex was used to evaluate the association between vascular bed number/location(s) affected and
MACE
. We identified 1 302 856 patients with established atherosclerotic disease or risk factors for atherosclerosis. Coronary artery disease was present in 16.9% of patients, cerebrovascular disease in 7.6%, peripheral artery disease in 13.6%, and risk factors for atherosclerosis only in 66.0%. The 1‐ and 4‐year incidences of
MACE
were 1.4% and 6.9%, respectively. At 4 years,
MACE
was more frequent in patients with atherosclerotic disease in a single (hazard ratio=1.51, 95%
CI
=1.48–1.55), 2‐(hazard ratio=2.35, 95%
CI
=2.27–2.44), or all 3 vascular beds (hazard ratio=3.30, 95%
CI
=2.97–3.68) compared with having risk factors for atherosclerosis.
Conclusions
Patients with established atherosclerotic disease or who have multiple risk factors and are treated in contemporary, routine practice carry a substantial risk for
MACE
at 1‐ and 4‐ years of follow‐up.
MACE
risk was shown to vary based on the number and location of vascular beds involved.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Cardiology and Cardiovascular Medicine
Reference24 articles.
1. Deaths: leading causes for 2015;Heron M;Natl Vital Stat Rep,2017
2. Comparative Determinants of 4-Year Cardiovascular Event Rates in Stable Outpatients at Risk of or With Atherothrombosis
3. One-Year Cardiovascular Event Rates in Outpatients With Atherothrombosis
4. Decline in Cardiovascular Mortality
5. IBM Watson Health
. White Paper: IBM MarketScan Research Databases for Health Services Researchers. April 2019. Available at: https://www.ibm.com/downloads/cas/6KNYVVQ2. Accessed November 21 2019.
Cited by
66 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献