Acute Myocardial Infarction and Associated Healthcare Resource Utilization and Costs Among U.S. Patients With Extreme High Versus Low Lipoprotein (a)
Author(s)
Cory Pack, BS, Maria Weck, MPH, Monica Silver, PhD, MPH, Joana Tome, MPH, Natalia Coenen, MPH, Maryam Ajose, MPH, Elizabeth Marchlewicz, PhD, MPH, Janna Manjelievskaia, MPH, PhD;
Veradigm, Chicago, IL, USA
Veradigm, Chicago, IL, USA
Presentation Documents
OBJECTIVES: Elevated lipoprotein (a) [Lp(a)] is associated with increased cardiovascular risk. This research aims to examine this risk’s burden by comparing all-cause and acute myocardial infarction (AMI)-related healthcare resource utilization and costs (HRU&C) among patients with extremely high (XHI) vs. low (LO) Lp(a) levels.
METHODS: We identified adults with ≥1 Lp(a) lab results between 01/01/2016-01/31/2023 (earliest lab+30 days=index) using NLP-enhanced linked data from Veradigm Network EHR and Komodo Health claims. Patients had EHR/claims activity ≥13 months pre- and ≥12 months post-index with no severe kidney/liver dysfunction or malignant neoplasm during the study period, and no ischemic stroke, MI, or coronary revascularization in baseline. Cohorts were stratified by Lp(a) levels and used inverse probability treatment weighting to balance baseline characteristics between cohorts. All-cause and AMI-related HRU&C were reported in the variable-length follow-up period.
RESULTS: Of 22,289 patients with an Lp(a) lab value, 2,233 and 11,023 were in the weighted XHI and LO cohorts, respectively. Mean (SD) Lp(a) (nmol/L) was 303.9 (78.0) vs. 21.1 (10.6) (p<0.0001). Baseline lipids (total cholesterol, LDL, HDL, triglycerides) differed significantly between XHI vs. LO (all p<0.0001). Mean follow-up length was similar across cohorts (1,420.0 [SD=2,210.8] days). AMI was rare and did not vary by cohort (1.6% vs. 1.5%). No differences in all-cause inpatient (IP) admissions (13.0% vs. 13.9%), emergency department (ED) visits (39.6% vs. 36.3%), or mean per patient per year (PPPY) IP ($16,215 vs. 15,445) and ED ($2,036 vs. $2,122) costs by cohort were seen. AMI-related IP admissions (52.7% vs. 61.1%) and ED visits (25.3% vs. 10.8%) differed while PPPY costs were similar for IP ($42,898 vs. $41,485) and ED ($6,687 vs. $6,198).
CONCLUSIONS: After weighting, XHI Lp(a) patients did not have a greater risk of AMI. The similarity in all-cause and AMI-related PPPY HRU&C suggests acute events (e.g., AMI) may not have sustained the burden of chronic conditions.
METHODS: We identified adults with ≥1 Lp(a) lab results between 01/01/2016-01/31/2023 (earliest lab+30 days=index) using NLP-enhanced linked data from Veradigm Network EHR and Komodo Health claims. Patients had EHR/claims activity ≥13 months pre- and ≥12 months post-index with no severe kidney/liver dysfunction or malignant neoplasm during the study period, and no ischemic stroke, MI, or coronary revascularization in baseline. Cohorts were stratified by Lp(a) levels and used inverse probability treatment weighting to balance baseline characteristics between cohorts. All-cause and AMI-related HRU&C were reported in the variable-length follow-up period.
RESULTS: Of 22,289 patients with an Lp(a) lab value, 2,233 and 11,023 were in the weighted XHI and LO cohorts, respectively. Mean (SD) Lp(a) (nmol/L) was 303.9 (78.0) vs. 21.1 (10.6) (p<0.0001). Baseline lipids (total cholesterol, LDL, HDL, triglycerides) differed significantly between XHI vs. LO (all p<0.0001). Mean follow-up length was similar across cohorts (1,420.0 [SD=2,210.8] days). AMI was rare and did not vary by cohort (1.6% vs. 1.5%). No differences in all-cause inpatient (IP) admissions (13.0% vs. 13.9%), emergency department (ED) visits (39.6% vs. 36.3%), or mean per patient per year (PPPY) IP ($16,215 vs. 15,445) and ED ($2,036 vs. $2,122) costs by cohort were seen. AMI-related IP admissions (52.7% vs. 61.1%) and ED visits (25.3% vs. 10.8%) differed while PPPY costs were similar for IP ($42,898 vs. $41,485) and ED ($6,687 vs. $6,198).
CONCLUSIONS: After weighting, XHI Lp(a) patients did not have a greater risk of AMI. The similarity in all-cause and AMI-related PPPY HRU&C suggests acute events (e.g., AMI) may not have sustained the burden of chronic conditions.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE467
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory)