Economic burden associated with systemic inflammation in patients with HFmrEF/HFpEF

Systemic inflammation (SI), detected via high-sensitivity C-reactive protein (hsCRP) testing, has a recognized role in the pathogenesis and long-term outcomes in cardiovascular disease. However, SI in patients with heart failure (HF) with mildly reduced or preserved ejection fraction (HFmrEF/HFpEF) is less characterized. This study aimed to evaluate the impact of SI on real-world healthcare resource utilization (HCRU) and costs.

This retrospective cohort study included patients within the Komodo Healthcare Map database between January 2016 and April 2024. HFmrEF/HFpEF was classified using a validated claims-based algorithm. Patients with a valid hsCRP test were classified as with SI (hsCRP 2-10 mg/L) or without SI (hsCRP <2 mg/L). Inverse probability of treatment weighting was used to balance patients based on demographic and clinical covariates. During the follow-up period (minimum 12 months following hsCRP test and HF diagnosis), HCRU was summarized descriptively, and per-patient per-year costs (adjusted to April 2024 USD) were estimated using generalized linear models or two-part models.

Among 7,242 propensity-weighted patients with HFmrEF/HFpEF and an eligible hsCRP test, HCRU and costs were greater among those with SI (n = 3,299) vs without SI (n = 3,943). SI was associated with higher mean per-patient per-year costs; the total medical cost difference between groups was $3,329 (95% confidence interval [CI]: 1,802-4,857), including all-cause outpatient visits ($1,175 [95% CI: 302-2,049]) and hospitalizations ($1,666 [95% CI: 845-2,488]).

SI was associated with increased economic and resource burden among patients with HFmrEF/HFpEF. SI testing may have a potential role in identifying those likely to have higher HCRU.