Predictors of costs related to cardiovascular disease among patients with atrial fibrillation in five European countries

Abstract

Aims: To estimate predictors of direct costs and costs of hospitalization related to cardiovascular disease (CVD) in patients with atrial fibrillation (AF) recruited to the Euro Heart Survey on AF (EHS-AF) in Greece, Italy, Poland, Spain, and the Netherlands.

Methods and results: Annual direct costs were modelled by country using ordinary least squares (OLS) regression. For costs of hospitalization related to CVD, logistic regressions followed by conditional OLS regression were employed. In each case, effects of the following potential explanatory variables were tested: age, sex, body mass index, type of AF, diabetes, hypertension, myocardial infarction (MI), angina pectoris (AP), valvular heart disease (VHD), congestive heart failure (CHF), stroke, and/or other underlying heart disease at the time of enrolment in the EHS-AF. Estimated direct annual costs for the reference EHS-AF patient (female aged <65 years with first-detected AF and no co-morbidities at baseline) were €933 in Greece, €1383 in Italy, €698 in Poland, €1316 in Spain, and €1544 in the Netherlands. The co-morbidities identified as predictors of direct costs were VHD in Greece, Italy, and Spain, AP in Italy and Spain, diabetes and stroke in Poland, CHF in Italy, MI in Spain and other underlying heart disease in Poland and the Netherlands. For costs of CVD-related hospitalization, the most important co-morbidity identified as a predictor was VHD.

Conclusion: The results reported in this study increase the understanding of the cost structure of CVD in AF patients and may therefore inform the targeting of intervention therapy in selected groups of at-risk patients.