Risk estimation for recurrent cardiovascular events using the SMART-REACH model and direct inpatient cost profiling in Indonesian ASCVD patients: a large-scale multicenter study Article Swipe
Bambang Dwiputra
,
Dwita Rian Desandri
,
Anggoro Budi Hartopo
,
Dafsah Arifa Juzar
,
Amir Aziz Alkatiri
,
Naufal Zuhdi
,
Putra Andito Ramadhan
,
Bernadhet Daisy Kenconosari
,
Jason Phowira
,
Bambang Widyantoro
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.3389/fcvm.2024.1425703
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.3389/fcvm.2024.1425703
Introduction 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. Objectives 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. Methods 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. Results 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). Conclusions 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.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.3389/fcvm.2024.1425703
- https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2024.1425703/pdf
- OA Status
- gold
- References
- 26
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4401277271
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4401277271Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.3389/fcvm.2024.1425703Digital Object Identifier
- Title
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Risk estimation for recurrent cardiovascular events using the SMART-REACH model and direct inpatient cost profiling in Indonesian ASCVD patients: a large-scale multicenter studyWork title
- Type
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articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2024Year of publication
- Publication date
-
2024-08-02Full publication date if available
- Authors
-
Bambang Dwiputra, Dwita Rian Desandri, Anggoro Budi Hartopo, Dafsah Arifa Juzar, Amir Aziz Alkatiri, Naufal Zuhdi, Putra Andito Ramadhan, Bernadhet Daisy Kenconosari, Jason Phowira, Bambang WidyantoroList of authors in order
- Landing page
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https://doi.org/10.3389/fcvm.2024.1425703Publisher landing page
- PDF URL
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https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2024.1425703/pdfDirect link to full text PDF
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YesWhether a free full text is available
- OA status
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goldOpen access status per OpenAlex
- OA URL
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https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2024.1425703/pdfDirect OA link when available
- Concepts
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Medicine, Percutaneous coronary intervention, Myocardial infarction, Conventional PCI, Emergency medicine, Risk assessment, Internal medicine, Intensive care medicine, Computer security, Computer scienceTop concepts (fields/topics) attached by OpenAlex
- Cited by
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0Total citation count in OpenAlex
- References (count)
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26Number of works referenced by this work
- Related works (count)
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10Other works algorithmically related by OpenAlex
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| corresponding_institution_ids | https://openalex.org/I29617571, https://openalex.org/I4210097300 |
| citation_normalized_percentile.value | 0.13343879 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | False |