OBJECTIVES

To assess healthcare resource utilization (HRU) and costs of myocardial infarction (MI) in patients with history of atherosclerotic cardiovascular disease (ASCVD) in Germany.

METHODS

We conducted a retrospective study using the “Institute for Applied Health Research Berlin” (InGef) Research Database, which contains claims data of approximately 4 million individuals. We included adult patients who had history of ASCVD and were on lipid-lowering therapy between 1/1/2012 and 31/12/2013. Index event was defined as a hospitalization for MI, unstable angina, or stroke between 1/1/2014 and 31/12/2016. ASCVD patients were matched 1:2 to patients without an index event based on age, gender, type of ASCVD, and risk factors (heart failure, smoking, hypertension, diabetes mellitus, lipid disorders, obesity, and chronic kidney disease). For this analysis, we selected a subgroup of patients with history of MI and their matched controls. HRU and costs were assessed during a one-year follow-up.

RESULTS

We identified 3,717 patients with history of MI (mean age: 73.8 years, 31.0% female) and 7,434 matched controls. Of the patients with history of MI, 194 (5.2%) had a subsequent MI within one year of their index MI. Compared to the matched controls, MI patients had, on average, 7.0 additional outpatient visits, 1.8 additional all-cause hospitalizations, and 1.2 additional ASCVD-related hospitalizations during the first year after their index MI. The average cost of the index MI hospitalization was €7,000 (SD: €10,144). The average total healthcare costs during the year following the index date were €20,360 (SD: €23,681) for patients with a prior MI compared to €4,011 (SD: €9,282) for matched controls.

CONCLUSIONS

MI is associated with a significant increase in HRU and costs during the first year. More aggressive measures directed at prevention of subsequent MI in very high-risk patients might improve clinical outcomes and help lower the economic burden on healthcare systems.