INCIDENCE AND COSTS OF SECONDARY STROKE EVENTS IN PATIENTS WITH ISCHEMIC STROKE OR TRANSIENT ISCHEMIC ATTACK OF NON-CARDIOEMBOLIC ORIGIN
Author(s)
Michael A. Head, MS1, Valerie Haley, PhD1, Emily Durden, PhD2, Steven Caproni, PharmD2, Gilbert Ko, MBA, MS, PharmD2, Vincent Willey, PharmD, BCACP1, Kaitlyn Hopkins, BS1, Jean Lee, PharmD, MS2, Seemant Chaturvedi, MD, FAHA3, Lynda D. Lisabeth, PhD4.
1Carelon Research, Wilmington, DE, USA, 2Bayer HealthCare Pharmaceuticals Inc., Whippany, NJ, USA, 3University of Maryland School of Medicine, Baltimore, MD, USA, 4Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA.
1Carelon Research, Wilmington, DE, USA, 2Bayer HealthCare Pharmaceuticals Inc., Whippany, NJ, USA, 3University of Maryland School of Medicine, Baltimore, MD, USA, 4Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA.
OBJECTIVES: Secondary stroke substantially contributes to morbidity, mortality, and healthcare burden among patients with non-cardioembolic ischemic stroke (IS) or transient ischemic attack (TIA). This study evaluated the real-world incidence of secondary IS, demographic and clinical characteristics associated with recurrence, and the costs of secondary stroke events.
METHODS: This retrospective cohort study utilized the Healthcare Integrated Research Database (HIRD®), a large, nationwide, US real-world data source, to identify adults with non-cardioembolic IS or TIA (index event) from 01/01/2016-06/30/2024. Secondary IS was defined as a hospitalization or emergency department visit with an International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnosis of IS following the index event. Time to a composite outcome of secondary IS or death was assessed using a Kaplan-Meier curve. Total medical costs were calculated for secondary stroke events.
RESULTS: Among 80,864 eligible individuals (mean [standard deviation (SD)] age 62.4 [13.7] years; 51.4% male; 75.9% non-Hispanic White), 5,715 (7.1%) experienced at least one secondary IS over a mean (SD) follow-up of 2.3 (2.1) years. Secondary IS was more common following an index of IS (8.1%) than TIA (3.8%). Patients with secondary IS had a higher prevalence of comorbidities, including diabetes (38.9% vs 26.4%) and coronary artery disease (19.4% vs 14.4%). Survival without secondary IS or death was 89.6% at 1 year and 77.7% at 4 years, and the risk of recurrence was elevated both early, especially within 90 days, and throughout long-term follow-up. Mean (SD) total costs were $26,597 ($49,758) for the first secondary stroke and $25,860 ($41,252) for subsequent events.
CONCLUSIONS: Patients who experience secondary IS have a greater comorbidity burden and face high risk of recurrence or death both early and over the long-term, emphasizing the importance of early secondary prevention. Secondary strokes are also associated with substantial medical costs, highlighting the economic value of preventing recurrence.
METHODS: This retrospective cohort study utilized the Healthcare Integrated Research Database (HIRD®), a large, nationwide, US real-world data source, to identify adults with non-cardioembolic IS or TIA (index event) from 01/01/2016-06/30/2024. Secondary IS was defined as a hospitalization or emergency department visit with an International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnosis of IS following the index event. Time to a composite outcome of secondary IS or death was assessed using a Kaplan-Meier curve. Total medical costs were calculated for secondary stroke events.
RESULTS: Among 80,864 eligible individuals (mean [standard deviation (SD)] age 62.4 [13.7] years; 51.4% male; 75.9% non-Hispanic White), 5,715 (7.1%) experienced at least one secondary IS over a mean (SD) follow-up of 2.3 (2.1) years. Secondary IS was more common following an index of IS (8.1%) than TIA (3.8%). Patients with secondary IS had a higher prevalence of comorbidities, including diabetes (38.9% vs 26.4%) and coronary artery disease (19.4% vs 14.4%). Survival without secondary IS or death was 89.6% at 1 year and 77.7% at 4 years, and the risk of recurrence was elevated both early, especially within 90 days, and throughout long-term follow-up. Mean (SD) total costs were $26,597 ($49,758) for the first secondary stroke and $25,860 ($41,252) for subsequent events.
CONCLUSIONS: Patients who experience secondary IS have a greater comorbidity burden and face high risk of recurrence or death both early and over the long-term, emphasizing the importance of early secondary prevention. Secondary strokes are also associated with substantial medical costs, highlighting the economic value of preventing recurrence.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE215
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory)