Cardiovascular Event Rate and Mortality Among Primary-Prevention Hypercholesterolemia Patients in Japan
Author(s)
Tomohiro Kondo, MSc1, Yilong Zhang, MD2, Kentaro Yamato, PhD3.
1HEOR/RWE, Otsuka Phamaceutical Co.,Ltd., Minato-ku, Japan, 2Otsuka phama, Tokyo, Japan, 3Otsuka Holdings Co., Ltd., Tokyo, Japan.
1HEOR/RWE, Otsuka Phamaceutical Co.,Ltd., Minato-ku, Japan, 2Otsuka phama, Tokyo, Japan, 3Otsuka Holdings Co., Ltd., Tokyo, Japan.
OBJECTIVES: Hypercholesterolemia is a major modifiable risk factor for atherosclerotic cardiovascular disease. In Japan, the burden of hypercholesterolemia is rising, highlighting the critical need for effective primary prevention. However, few studies have comprehensively examined the progression from primary to subsequent cardiovascular events. This study aimed to characterize the distribution and timing of first and second cardiovascular events using a claims database.
METHODS: We conducted a retrospective cohort analysis using the Diagnosis Procedure Combination database from Medical Data Vision Co., Ltd. (Tokyo, Japan), covering April 2008 to March 2024. The analysis was conducted using Prospection’s analytics platform to identify primary cardiovascular events, subsequent events, and the time to each. Additionally, myocardial infarction (MI), ischemic stroke (IS) and unstable angina (UA) were defined using ICD-10 code as follows; MI (I21-22), IS (I63) and UA (I20.0). The index date was defined as the date of hospitalization due to any of the IS, MI, or UA. Patients with records of all cancer, liver cirrhosis, or dialysis within three-months before or after the index date were excluded, while those with hypercholesterolemia (E78.0) during the same period were included.
RESULTS: A total of 212,363 patients with hypercholesterolemia and no prior history of cardiovascular event were identified. The first cardiovascular events were distributed as follows: IS (45.5%), MI (35.3%), and UA (19.2%). Among second events, IS accounted for 35.1%, MI for 10.5%, UA for 42.6%, and death for 11.9%. The mean time to second events was 22.3 months for IS, 26.4months for MI, 12.8 months for UA, and 1.9 months for death.
CONCLUSIONS: These findings highlight a substantial early mortality risk following initial cardiovascular events, with death occurring on average just over two month later. These results emphasize the need for sustained cardiovascular risk management even among primary prevention populations.
METHODS: We conducted a retrospective cohort analysis using the Diagnosis Procedure Combination database from Medical Data Vision Co., Ltd. (Tokyo, Japan), covering April 2008 to March 2024. The analysis was conducted using Prospection’s analytics platform to identify primary cardiovascular events, subsequent events, and the time to each. Additionally, myocardial infarction (MI), ischemic stroke (IS) and unstable angina (UA) were defined using ICD-10 code as follows; MI (I21-22), IS (I63) and UA (I20.0). The index date was defined as the date of hospitalization due to any of the IS, MI, or UA. Patients with records of all cancer, liver cirrhosis, or dialysis within three-months before or after the index date were excluded, while those with hypercholesterolemia (E78.0) during the same period were included.
RESULTS: A total of 212,363 patients with hypercholesterolemia and no prior history of cardiovascular event were identified. The first cardiovascular events were distributed as follows: IS (45.5%), MI (35.3%), and UA (19.2%). Among second events, IS accounted for 35.1%, MI for 10.5%, UA for 42.6%, and death for 11.9%. The mean time to second events was 22.3 months for IS, 26.4months for MI, 12.8 months for UA, and 1.9 months for death.
CONCLUSIONS: These findings highlight a substantial early mortality risk following initial cardiovascular events, with death occurring on average just over two month later. These results emphasize the need for sustained cardiovascular risk management even among primary prevention populations.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EPH35
Topic
Epidemiology & Public Health, Real World Data & Information Systems
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory)