Burden of new hospitalization for heart failure: a population‐based investigation from Italy

Corrao, Giovanni; Ghirardi, Arianna; Ibrahim, Buthaina; Merlino, Luca; Maggioni, Aldo P.

doi:10.1002/ejhf.105

Cited by 80 publications

(57 citation statements)

References 39 publications

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“…Per‐patient per‐year (PPPY) inpatient, outpatient and pharmacy resource utilization and costs to treat EHMs in each of the EU5 were obtained from the literature, national databases and fee schedules, or expert opinion if otherwise unavailable (Table ). All costs were adjusted to 2016 euros (€), using a pound sterling to euro exchange rate of 1.15.…”

Section: Methodsmentioning

confidence: 99%

Direct medical costs associated with the extrahepatic manifestations of hepatitis C infection in Europe

Cacoub

Buggisch

Carrión

et al. 2018

Journal of Viral Hepatitis

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Hepatitis C virus (HCV) infection is a systemic disease associated with both hepatic and extrahepatic manifestations. The burden associated with the hepatic manifestation of HCV infection has been well documented in Europe, although that of HCV extrahepatic manifestations remains unknown. In this study, we estimated the annual direct medical costs associated with HCV extrahepatic manifestations in five European countries. A previously validated economic model was used to estimate the annual direct medical cost associated with HCV extrahepatic manifestations. Global excess prevalence of extrahepatic manifestations in HCV patients relative to that in non-HCV patients was obtained from a recent meta-analysis. Per-patient per-year inpatient, outpatient and medication costs to treat each extrahepatic manifestation were from the literature, national databases or expert opinion if unavailable otherwise. All costs were adjusted to 2016 euros (€). The overall direct medical costs associated with HCV extrahepatic manifestations were calculated by multiplying the total per-patient per-year costs of each by the respective excess prevalence rates and then by the size of the HCV-infected population in each country. Treatment impact with direct-acting antivirals (DAAs) was explored using HCV extrahepatic manifestations excess prevalence rates among cured patients compared to untreated HCV patients, as sourced from a meta-analysis. The total annual direct medical cost associated with HCV extrahepatic manifestations was estimated to be 2.17 billion euro (€), with a per-HCV-patient cost ranging from €899 to €1647 annually. DAA treatment was projected to result in cost savings of €316 million per year. We find that the annual economic burden of extrahepatic manifestations is significant and may be partly mitigated by treatment with DAAs.

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Section: Methodsmentioning

confidence: 99%

Direct medical costs associated with the extrahepatic manifestations of hepatitis C infection in Europe

Cacoub

Buggisch

Carrión

et al. 2018

Journal of Viral Hepatitis

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“…40 In fact, the incidence of almost 37.5 heart failure cases every 10 000 person years observed in our study does not substantially differ from rates reported by available population based studies. 41 Still, even with some outcome misclassification, 42 this is expected to be non-differential-that is, independent of current use of NSAIDs-leading to a bias moving estimated associations towards the null. 43 However, non-differential misclassification (of outcome or exposure) might lead to inflated observed associations due to chance alone.…”

Section: Dose Class Celecoxibmentioning

confidence: 99%

Non-steroidal anti-inflammatory drugs and risk of heart failure in four European countries: nested case-control study

Arfè

Scotti

Varas‐Lorenzo³

et al. 2016

BMJ

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229

105

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ObjeCtivesTo investigate the cardiovascular safety of nonsteroidal anti-inflammatory drugs (NSAIDs) and estimate the risk of hospital admission for heart failure with use of individual NSAIDs. DesignNested case-control study.setting Five population based healthcare databases from four European countries (the Netherlands, Italy, Germany, and the United Kingdom). PartiCiPantsAdult individuals (age ≥18 years) who started NSAID treatment in 2000-10. Overall, 92 163 hospital admissions for heart failure were identified and matched with 8 246 403 controls (matched via risk set sampling according to age, sex, year of cohort entry). Main OutCOMe MeasureAssociation between risk of hospital admission for heart failure and use of 27 individual NSAIDs, including 23 traditional NSAIDs and four selective COX 2 inhibitors. Associations were assessed by multivariable conditional logistic regression models. The dose-response relation between NSAID use and heart failure risk was also assessed.

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“…Details of healthcare utilization databases of the Lombardy Region and of their use in the field of cardiovascular diseases have been reported elsewhere. 4,7,10,11 these, those who received at least 1 antihypertensive drug prescription during 2005 were identified, and the first dispensation was defined as the index prescription. Antihypertensive drugs included diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, β-blockers, and calcium-channel blockers (CCBs) initially dispensed as monotherapy.…”

Section: Settingmentioning

confidence: 99%

“…7 However, few investigations have so far assessed the effect of adherence with antihypertensive treatment on the risk of HF in the setting of clinical practice 8 making the real-world evidence on this issue still incompletely known. This is an important gap of knowledge because HF is (1) the most common cause of hospitalization in the elderly, 9 with a high hospital readmission, mortality rate, 10,11 and cost 12 and (2) more and more frequently diagnosed 13 because of ageing of the population and better survival of patients from an acute coronary event.…”

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confidence: 99%

Adherence With Antihypertensive Drug Therapy and the Risk of Heart Failure in Clinical Practice

et al. 2015

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Abstract-Randomized clinical trials have shown that antihypertensive treatment reduces the risk of heart failure (HF).Limited evidence exists, however, on whether and to what extent this benefit is translated into real-life practice. A nested case-control study was carried out by including the cohort of 76 017 patients from Lombardy (Italy), aged 40 to 80 years, who were newly treated with antihypertensive drugs during 2005. Cases were the 622 patients who experienced hospitalization for HF from initial prescription until 2012. Up to 5 controls were randomly selected for each case. Logistic regression was used to model the HF risk associated with adherence to antihypertensive drugs, which was measured by the proportion of days covered by treatment (PDC). Data were adjusted for several covariates. Sensitivity analyses were performed to account for possible sources of systematic uncertainty. Compared with patients with very low adherence (PDC, ≤25%), low, intermediate, and high adherences were associated with progressively lower risk of HF, reduction in the high-adherence group (>75%) being 34% (95% confidence interval, 17%-48%). Similar effects were observed in younger (40-70 years) and older (71-80 years) patients and between patients treated with angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and diuretics. There was no evidence that adherence with calciumchannel blockers reduced the HF risk. Antihypertensive treatment lowers the HF risk in real-life practice, but adherence to treatment is necessary for a substantial benefit to take place. This is the case with a variety of antihypertensive drugs. Corrao et al Antihypertensive Agents and Heart Failure 743these, those who received at least 1 antihypertensive drug prescription during 2005 were identified, and the first dispensation was defined as the index prescription. Antihypertensive drugs included diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, β-blockers, and calcium-channel blockers (CCBs) initially dispensed as monotherapy. Patients with an initial prescription of ≥2 antihypertensive drugs were excluded to reduce the range of hypertension severity, given that compared with monotherapy, need of multiple drug treatment reflects an increased risk of cardiovascular events, including HF. 14 Exclusion was extended to other patient categories, such as patients who (1) received at least 1 antihypertensive drug prescription within the 5 years before the index prescription, to limit inclusion to newly treated individuals; (2) had been hospitalized for cardiovascular disease or used drugs for coronary heart disease or HF, within the 5 years before the index prescription to limit data collection to the setting of primary cardiovascular prevention; (3) were beneficiaries of the National Health Service from <5 years before the start of prescription; and (4) did not reach at least 1 year of followup. Patients who had previously received ≥1 prescriptions of digitalis were also excluded because the use of digi...

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Burden of new hospitalization for heart failure: a population‐based investigation from Italy

Cited by 80 publications

References 39 publications

Direct medical costs associated with the extrahepatic manifestations of hepatitis C infection in Europe

Direct medical costs associated with the extrahepatic manifestations of hepatitis C infection in Europe

Non-steroidal anti-inflammatory drugs and risk of heart failure in four European countries: nested case-control study

Adherence With Antihypertensive Drug Therapy and the Risk of Heart Failure in Clinical Practice

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