Health Care Burden of Dyspepsia Among Nonvalvular Atrial Fibrillation Patients

Abstract

A trial fibrillation (AF) is the most common cardiac arrhythmic disorder in the United States and is estimated to affect approximately 1% of adult Americans, of which the majority (~85%) are 65 years of age and older. 1,2 With the growing elderly population in the United States, the prevalence of AF is expected to more than double by 2050. 1,2People with AF have up to a 5-fold increased risk of stroke, with stroke risk being highest for persons between the ages of 80 and 89.3 Another common condition more frequent in persons older than 65 years of age is dyspepsia, a gastrointestinal (GI) disorder widely defined by symptoms of postprandial fullness, early satiation, and epigastric pain, or discomfort or burning in the absence of causative structural disease. 4 A review of several U.S. studies reported that the pooled prevalence of dyspeptic, gastroesophageal, and dyspeptic and/or gastroesophageal symptoms was 16.3% among the general U.S. population. Patients with 1 inpatient or 2 outpatient dyspepsia diagnoses within 12 months following any NVAF diagnosis were grouped into the dyspeptic cohort, and patients without any dyspepsia diagnosis were grouped into the nondyspeptic cohort. Of the overall cohorts, patients were matched by key patient characteristics. Dyspepsia was further categorized as having a prior history of dyspepsia (chronic) or no dyspepsia (nonchronic) during the baseline period. Health care resource utilization, associated costs, and warfarin use were evaluated during a 12-month follow-up period.RESULTS: Of NVAF patients included in the study (N = 142,322), 10.4% were diagnosed with dyspepsia. After matching for key characteristics, NVAF patients with dyspepsia had significantly greater inpatient, outpatient, and prescription claims per patient year than those without dyspepsia (1.24 ± 1.21 vs. 0.36±0.68, P < 0.0001; 110.18 ± 101.03 vs. 66.98 ± 72.43, P < 0.0001; and 52.13 ± 35.30 vs. 44.29 ± 32.41, P < 0.0001, respectively).

Incremental economic burden associated with major bleeding among atrial fibrillation patients treated with factor Xa inhibitors

“…The primary objective of this study is to evaluate the incremental cost burden of patients with MB. Therefore, we compared patients with MB to patients without MB to assess this incremental burden, which is a common approach for such types of data analysis 11,12 .…”

“…However, within the confines of the recorded information contained within administrative claims database and the primary objective of this analysis (i.e. assess the incremental economic burden of MB), the regression analyses were an appropriate methodology and commonly used in other similar published studies 11,12 . Also, in this study patients might have been receiving concomitant anti-platelet medications and/or other over-the-counter treatments (e.g.…”