Real-World Demographic and Clinical Characteristics of Patients With Atherosclerotic Cardiovascular Disease With or Without Chronic Kidney Disease or Systemic Inflammation in the United States
Author(s)
Chi Nguyen, PhD1, Allegra Kaufman, MD1, Brenna Brady, PhD2, Ryan Ross, MS2, Wing Chow, PharmD, MPH1, Aarth Sheth, PharmD, RPh1, Radha Ryali, MS1, Weilong Li, PhD1, Jeffrey R. Skaar, PhD1;
1Novo Nordisk Inc., Plainsboro, NJ, USA, 2Merative, Ann Arbor, MI, USA
1Novo Nordisk Inc., Plainsboro, NJ, USA, 2Merative, Ann Arbor, MI, USA
Presentation Documents
OBJECTIVES: Systemic inflammation (SI) is associated with increased risk of cardiovascular events in patients with atherosclerotic cardiovascular disease (ASCVD). This study describes demographic and clinical characteristics and major adverse cardiovascular events (MACE) in patients with ASCVD ± chronic kidney disease (CKD), with or without SI.
METHODS: This retrospective study used Merative™ MarketScan® Research Databases (1Oct2016-30Sep2022) to identify patients with ASCVD from claims using ICD-10 codes. CKD stage was determined from claims or laboratory estimated glomerular filtration rate. SI status was identified using laboratory high-sensitivity C-reactive protein (2-10mg/L). Demographics, clinical characteristics, and 2-point MACE (non-fatal myocardial infarction or stroke) incidence rate were reported.
RESULTS: Among 3,358 eligible patients with ASCVD, 54% were male, 30.5% were insured by Medicare, and mean age was 60 years. The percentage of patients with SI was 61%; 67% of females and 56% of males exhibited SI. For a limited sample of patients, those with CKD (n=301) were ≥9 years older (≥11 years for stage 3-4 CKD, n=172) than patients without CKD (n=3,057). Patients with and without SI were of similar age. Dyslipidemia (60%), hypertension (53%), and type 2 diabetes (T2D, 24%) were common comorbidities for the overall ASCVD study population. Hypertension (73%), dyslipidemia (70%), T2D (46%), and chronic pulmonary disease (16%) were the most common comorbidities in patients with ASCVD+CKD+SI; results were similar for stage 3-4 CKD. The 2-point MACE incidence rate for the overall ASCVD population was 9.5 per 1,000 person-years. Among patients with ASCVD without CKD, SI was associated with an increased risk of 2-point MACE (adjusted HR=1.89; 95% CI, 1.14-3.15; p=0.014).
CONCLUSIONS: In the overall ASCVD population, dyslipidemia, T2D, and hypertension were common comorbidities. SI was more common among females. In patients without CKD, SI was associated with increased risk of MACE. CKD was underestimated; further analysis with a larger sample size should be conducted for ASCVD+CKD.
METHODS: This retrospective study used Merative™ MarketScan® Research Databases (1Oct2016-30Sep2022) to identify patients with ASCVD from claims using ICD-10 codes. CKD stage was determined from claims or laboratory estimated glomerular filtration rate. SI status was identified using laboratory high-sensitivity C-reactive protein (2-10mg/L). Demographics, clinical characteristics, and 2-point MACE (non-fatal myocardial infarction or stroke) incidence rate were reported.
RESULTS: Among 3,358 eligible patients with ASCVD, 54% were male, 30.5% were insured by Medicare, and mean age was 60 years. The percentage of patients with SI was 61%; 67% of females and 56% of males exhibited SI. For a limited sample of patients, those with CKD (n=301) were ≥9 years older (≥11 years for stage 3-4 CKD, n=172) than patients without CKD (n=3,057). Patients with and without SI were of similar age. Dyslipidemia (60%), hypertension (53%), and type 2 diabetes (T2D, 24%) were common comorbidities for the overall ASCVD study population. Hypertension (73%), dyslipidemia (70%), T2D (46%), and chronic pulmonary disease (16%) were the most common comorbidities in patients with ASCVD+CKD+SI; results were similar for stage 3-4 CKD. The 2-point MACE incidence rate for the overall ASCVD population was 9.5 per 1,000 person-years. Among patients with ASCVD without CKD, SI was associated with an increased risk of 2-point MACE (adjusted HR=1.89; 95% CI, 1.14-3.15; p=0.014).
CONCLUSIONS: In the overall ASCVD population, dyslipidemia, T2D, and hypertension were common comorbidities. SI was more common among females. In patients without CKD, SI was associated with increased risk of MACE. CKD was underestimated; further analysis with a larger sample size should be conducted for ASCVD+CKD.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EPH162
Topic
Epidemiology & Public Health
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory), SDC: Urinary/Kidney Disorders