Related Experiment Video
Updated: May 13, 2026
Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
Published on: August 9, 2024
Outcomes and excess costs among patients with cardiovascular disease
Zanfina Ademi1, Danny Liew, Ella Zomer
1Melbourne EpiCentre, Department of Medicine (The Royal Melbourne Hospital), The University of Melbourne, Australia; Department of Epidemiology & Preventive Medicine, Monash University, Australia.
Insights
Peripheral artery disease (PAD) patients experienced higher cardiovascular event rates and incurred significantly greater healthcare costs over two years. This highlights the substantial economic burden associated with PAD in Australia.
Area of Science:
- Cardiovascular Medicine
- Health Economics
- Public Health
Background:
- Cardiovascular disease (CVD) poses a significant health burden globally.
- Understanding event rates and associated costs is crucial for resource allocation and patient management.
- The Australian Reduction of Atherothrombosis for Continued Health (REACH) registry provides valuable data on patients with multiple risk factors and established atherosclerotic disease.
Purpose of the Study:
- To determine two-year cardiovascular event rates in patients within the REACH registry.
- To quantify the direct healthcare costs associated with cardiovascular disease in this cohort.
- To compare event rates and costs across different patient subgroups, including those with coronary artery disease (CAD), cerebrovascular disease (CerVD), and peripheral artery disease (PAD).
Main Methods:
- A prospective registry of 2873 Australian patients with multiple risk factors (MRF), CAD, CerVD, and PAD was analyzed.
- Two-year follow-up data were obtained for 2856 patients (99.4%).
- Direct healthcare costs (pharmaceuticals, outpatient, and hospitalisation) were calculated using 2011 Australian government reimbursement data.
Main Results:
- Patients with a history of PAD at baseline had the highest incidence of hospitalisation (49%) and cardiovascular death (5.1%).
- Non-fatal cardiovascular events were most common in PAD and CAD groups (21.8% and 14.1%, respectively).
- Patients with PAD incurred the highest excess mean total costs (A$4890) over two years compared to those with only MRF.
Conclusions:
- Peripheral artery disease (PAD) is associated with the highest likelihood of vascular interventions and cardiovascular death.
- Patients with PAD incur significantly higher excess healthcare costs.
- These findings underscore the substantial clinical and economic impact of PAD.
Objective:
To report on two-year cardiovascular (CV) event rates and quantify the cost of cardiovascular disease using the Australian Reduction of Atherothrombosis for Continued Health (REACH) registry.
Methods:
Prospective registry of 2873 patients with multiple risk factors (MRF), coronary artery disease (CAD), cerebrovascular disease (CerVD) and peripheral artery disease (PAD), recruited through 273 Australian general practitioners. Government reimbursement data from 2011 was used to calculate direct health care costs (pharmaceuticals, outpatient and hospitalisation costs). The main outcome of interest was two-year rates and associated excess costs of cardiovascular death, myocardial infarction, stroke, and hospitalisation for cardiovascular procedures.
Results:
The two year follow-up data were available for 2856 (99.4%) patients. Incidence of any hospitalisation and cardiovascular death was highest among those with previous history of PAD at baseline 49% (n=126), and 5.1% (n=13). Non-fatal cardiovascular events were highest among the PAD and CAD groups (21.8% (n=56) and 14.1% (n=297) respectively). Those with previous history of PAD and CerVD at baseline had the highest likelihood of CV death (OR=2.53 (95% CI: 1.58-4.08) and OR=1.61 (1.05-2.46) respectively) in comparison to other groups. Patients with PAD had the highest likelihood of vascular interventions OR=3.11 (95% CI: 2.09-4.63) at two years. Overall, the mean (SD) direct expenditure over two years of follow-up per person was A$7544 (A$10,758). In the adjusted model, patients with CAD and PAD incurred A$1093 (95% CI A$24 - A$2072) and A$4890 (95% CI A$3105 - A$6869) more in mean total costs compared to patients with MRF.
Conclusions:
Patients with PAD had the highest likelihood of vascular interventions and CV death, and incurred high excess costs in comparison to other groups.
Related Concept Videos
01:23Assessment of the Cardiovascular System I: Subjective Data
Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...
01:18Cardiovascular Drugs: Classification based on Therapeutic Indications
01:26Imbalances in Cardiac Output
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
01:27Coronary Artery Disease V: Interprofessional Care
01:29Cardiomyopathy VI: Nursing Management
01:29Cardiomyopathy V: Interprofessional Care