TORNA ALL’ELENCO

Patterns of treatment and healthcare costs of patients with acute coronary syndrome receiving dual antiplatelet therapy in Piedmont Region, Italy in European Heart Journal: Acute Cardiovascular Care

2013
ASL Città di Torino
ASL Torino 3

Tipo pubblicazione

Conference Abstract

Autori/Collaboratori (8)Vedi tutti...

Roggeri A
RSA Villa Serena, Bologna (BO), Italy
Gnavi R
RSA Villa Serena, Bologna (BO), Italy
Rusciani R
RSA Villa Serena, Bologna (BO), Italy

et alii...

Abstract

Purpose: This study aimed to assess the relapses of acute coronary syndrome (ACS) and the related direct healthcare costs during 12 months following a first ACS event in patients treated with dual antiplatelet therapy (aspirin and clopidogrel) in Piedmont Region, Italy. Methods: In 2008, all hospitalizations, drug prescriptions and outpatient episodes of care registered in the regional administrative databases were considered to estimate ACS relapses and direct healthcare costs. Identification of subjects in ascertained dual antiplatelet therapy was carried out through the prescriptions of aspirin plus clopidogrel in the 2 months following hospital discharge of first ACS event (index event). The analysis was performed from the Piedmont Regional Health Service perspective. Results: Overall, among subjects with a first ACS event in 2008, dual antiplatelet therapy was confirmed in 3,538 patients (average age 66,5 years; 29% females). During follow-up period, 88.8% (n:3,141) had no recurrence of ACS, while an ACS relapse was detected in 21.3% (n:126) of patients treated medically at index event, in 9.2% (n:270) of patients treated with PCI and in 4.6% (n:1) of patients undergoing CABG. A multivariate analysis considering as independent variables age, gender, type of treatment at index event (medical treatment or PCI) and type of ACS (STEMI, NSTEMI and UA) showed that the only variable significantly related to probability of ACS relapse was the type of treatment at index event (OR for PCI compared to medical treatment = 0.34; p<0.0001). In-hospital mortality for all causes during follow-up was 2.5% (n:88), while in-hospital cardiovascular mortality was 0.6% (n:21). The average annual healthcare cost per patient treated with dual antiplatelet therapy and alive at the end of follow-up (including index event cost) was €20,554 for patients with an ACS relapse treated medically (n:225), €22,172 for patients with ACS relapse treated with PCI (n:152) and €13,303 fo

DOI : 10.1177/2048872613501458

Keywords

gender; mortality; cardiovascular mortality; outpatient; recurrence risk; female; hospital discharge; health service; hospital; prescription; data base; follow up; relapse; Italy; therapy; acute coronary syndrome; hospitalization; patient; health care cost; human; clopidogrel; acetylsalicylic acid; independent variable; multivariate analysis; non ST segment elevation myocardial infarction;