Comparison of Medical Care Utilization and Costs Among Patients With Statin-Controlled Low-Density Lipoprotein Cholesterol With Versus Without Hypertriglyceridemia

Gregory A. Nichols, Sephy Philip, Kristi Reynolds, Craig B. Granowitz, Maureen O'Keeffe-Rosetti, Sergio Fazio

    Research output: Contribution to journalArticle

    1 Citation (Scopus)

    Abstract

    High triglyceride (TG) levels are associated with higher medical costs, but the long-term impact of high TG on costs among patients with statin-controlled low-density lipoprotein cholesterol (LDL-C) is unclear. We compared medical utilization and costs over 6.5 years between patients with high (200 to 400 mg/dl) versus normal (<150 mg/dl) TG levels, all of whom had established atherosclerotic cardiovascular disease (ASCVD). This was an observational cohort study of 17,183 patients with TG measured in 2010 and followed until death, disenrollment or the end of 2016. All patients had LDL-C levels between 40 and 100 mg/dl and were receiving statin therapy at the time of their TG measurement. We compared annualized medical utilization adjusted for differences between group in age, sex, race, and study site. We also compared annualized medical costs, further adjusting for baseline costs as a proxy for resource-intensive comorbidities. After multivariable adjustment, patients with high TG levels (n=2,702) had a mean of 13% more inpatient admissions per year (p <0.001). Despite adjustment for comorbidities such as diabetes and chronic kidney disease, total outpatient costs were 5% greater (p = 0.035) among those with high TG, including emergency care costs (6% greater) and hospital ambulatory costs (25% greater). The overall difference in annual costs of $964 per patient in the high TG cohort totaled over $2.6 million per year in excess annual costs and more than $13.5 million over the mean follow-up of 5.2 years.

    Original languageEnglish (US)
    JournalAmerican Journal of Cardiology
    DOIs
    StateAccepted/In press - Jan 1 2018

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    Hydroxymethylglutaryl-CoA Reductase Inhibitors
    Hypertriglyceridemia
    Health Care Costs
    LDL Cholesterol
    Triglycerides
    Costs and Cost Analysis
    Comorbidity
    Hospital Costs
    Emergency Medical Services
    Proxy
    Chronic Renal Insufficiency
    Observational Studies
    Inpatients
    Cohort Studies
    Outpatients
    Cardiovascular Diseases
    Age Groups

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine

    Cite this

    Comparison of Medical Care Utilization and Costs Among Patients With Statin-Controlled Low-Density Lipoprotein Cholesterol With Versus Without Hypertriglyceridemia. / Nichols, Gregory A.; Philip, Sephy; Reynolds, Kristi; Granowitz, Craig B.; O'Keeffe-Rosetti, Maureen; Fazio, Sergio.

    In: American Journal of Cardiology, 01.01.2018.

    Research output: Contribution to journalArticle

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