■随着印度尼西亚动脉粥样硬化性心血管疾病(ASCVD)病例的增加,越来越需要确定高危患者的心血管事件复发.风险分层可以指导最佳的二级预防治疗。了解ASCVD的直接住院费用可以进一步为减轻印度尼西亚大量ASCVD病例带来的经济负担提供见解。然而,印度尼西亚对这两个有价值的数据的大规模研究存在显着差距。采用SMART-REACH模型,我们可以描述印度尼西亚ASCVD患者心血管事件复发的风险.
■利用SMART-REACH模型估计印度尼西亚ASCVD患者心血管事件的10年和终生风险,并描述ASCVD的直接住院费用。
■这项描述性横断面研究收集了来自两个主要心血管中心的3,209名45-80岁的ASCVD患者的数据。参与者是2020年1月至2023年3月期间收治的ST段抬高型心肌梗死(STEMI)患者,非ST段抬高型心肌梗死(NSTEMI),和慢性冠状动脉综合征(CCS)需要择期经皮冠状动脉介入治疗(PCI)。SMART-REACH风险估计模型需要入院时的临床数据,入院前24小时内的实验室结果,出院时开的心血管药物。SMART-REACH模型是一种精细和灰色竞争风险模型,结合了心血管风险因素,可估计包括心肌梗死在内的复发性心血管事件的个体10年和终生风险。中风,或血管死亡。直接住院费用分析总计从ASCVD诊断入院到出院所产生的所有医疗费用。结果采用亚组分析进行描述性报道。
■队列(平均年龄60.15±8.6岁)主要是男性[n=2,537(79.1%)],高血压[n=2,267(70.6%)],并诊断为STEMI[n=1,732(54%)]。SMART-REACH模型计算的平均10年风险为30.2%(95%CI29.7-30.6),终生风险为62.5%(95%CI62.1-62.9)。ASCVD患者的直接住院费用包括中位数3,033美元,在STEMI亚组中,成本中位数最高(3,270美元)。
■大量印度尼西亚ASCVD患者表现出经历重大心血管事件的10年和终生风险。加上直接住院费用,治疗优化对于减轻这些风险和进一步的成本负担至关重要.
UNASSIGNED: With atherosclerotic cardiovascular disease (ASCVD) cases increasing in Indonesia, there is a growing need to identify high-risk patients for recurrent cardiovascular events. Risk stratification could guide optimal secondary preventive therapy. Understanding the ASCVD direct inpatient costs could further provide insight in reducing the economic burden that comes with Indonesia\'s high number ASCVD cases. However, there is a significant gap in Indonesian large-scale research on both of these valuable data. Employing the SMART-REACH model, we can profile the risk of recurrent cardiovascular events in Indonesian ASCVD patients.
UNASSIGNED: Utilize the SMART-REACH model to estimate 10-year and lifetime risk of cardiovascular events in Indonesian ASCVD patients and describe the direct inpatient cost of ASCVD.
UNASSIGNED: This descriptive cross-sectional study gathered data from 3,209 ASCVD patients aged 45-80 from two major cardiovascular centers using purposive sampling. Participants were patients admitted between January 2020 and March 2023 with ST-elevated myocardial infarct (STEMI), non-ST-elevated myocardial infarct (NSTEMI), and chronic coronary syndrome (CCS) requiring elective percutaneous coronary intervention (PCI). The SMART-REACH risk estimation model required clinical data upon admission, laboratory results within the first 24 h of admission, and cardiovascular medication prescribed upon discharge. The SMART-REACH model is a Fine and Gray competing risk model incorporating cardiovascular risk factors that estimates individual 10-year and lifetime risk for recurrent cardiovascular events which includes myocardial infarction, stroke, or vascular death. Direct inpatient cost profiling totaled all medical expenses incurred from ASCVD diagnosis admission to discharge. Results were reported descriptively with subgroup analyses.
UNASSIGNED: The cohorts (mean age 60.15 ± 8.6 years) were predominantly male [n = 2,537 (79.1%)], hypertensive [n = 2,267 (70.6%)], and diagnosed with STEMI [n = 1,732 (54%)]. The SMART-REACH model calculated a mean 10-year risk of 30.2% (95% CI 29.7-30.6) and a lifetime risk of 62.5% (95% CI 62.1-62.9). The direct inpatient cost of ASCVD patients includes a median 3,033 USD, with highest median costs in the STEMI subgroup (3,270 USD).
UNASSIGNED: A significant number of Indonesian ASCVD patients exhibited notably high 10-year and lifetime risks of experiencing a major cardiovascular event. Combined with the direct inpatient cost, therapy optimization is crucially needed to mitigate these risks and further cost burden.