OBJECTIVES

The risk groups designated for cardiovascular disease (CVD) secondary prevention were updated in the 2013 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines. This study estimated the impact of initiating secondary prevention using cholesterol-lowering medications on the risk of CVD-related hospitalization and on healthcare costs in patients qualifying for secondary prevention under the ACC/AHA Guidelines of 2013.

METHODS

The high-risk patients qualifying for secondary prevention under the 2013 guidelines were identified using diagnostic and hospitalization data for Humana [2007-2013]. Patients with an atherosclerotic cardiovascular event (ASCVD) were assumed eligible for secondary prevention. Patients with prior use of cholesterol-lowering medications before their index ASCVD date were then excluded. Patients were classified into ASCVD risk groups based on the CVD events that defined their index date. Patients were further designated into two treatment groups: [1] secondary prevention patients who initiated treatment before experiencing a second CVD-related hospitalization and [2] patients who did not initiate treatment until after experiencing a second CVD admission or who never initiated treatment. The impact of secondary prevention on the risk for cardiovascular hospitalization was estimated using Cox proportional hazards models. The impact of secondary prevention on healthcare costs was estimated using generalized linear models [GLM].

RESULTS CONCLUSIONS

Few patients designated for secondary prevention under the 2013 guidelines initiated treatment in the pre-guideline period [21%]. Patients who initiated secondary prevention experienced significantly reduced risks of a second CVD-related hospitalization.