Abstract 219: “Real World” Characterization of Patients with a Cardiac Event: A Case-Control Study

Background: Recent clinical intervention trials with neutral outcomes, enrolled patients with relatively well controlled risk cardiovascular (CV) risk factor profiles. The extent to which these patients reflect risks in the general population is unknown. Objective: To determine the baseline characteristics of new cardiac patients, and compare these with the general population and subjects enrolled in recent clinical trials. Methods: This was a retrospective claims database analysis. Cases were selected as patients with first occurrence of at least one cardiac event/procedure (coronary or cerebral event or revascularization procedure) between January 2005 and December 2008. The date of the event was set as the index date. Patients 18-64 years old with a lipid panel who enrolled during the year prior to the index date were selected. The cases were matched 1:3 on age, gender, and length of enrollment with controls who had no cardiac event but who also a lipid panel during the year prior. NCEP ATP III guidelines were used to determine lipid goals. Descriptive analyses were conducted to understand the similarities and differences between the cases and controls. Logistic regression was used to identify the potential predictors of cardiac events. Results: A total of 78,596 patients with an event were matched to 235,788 individuals in the general population. Average age was 54 years (SD 8.4) and 53.2% were men. Only 37.9% of cases compared to 49.3% of the general population had all three lipid values at goal. Irrespective of LDL-C levels, cases had higher a prevalence of elevated TG and depressed HDL-C than controls. In logistic regression, hypertension (OR 1.86 CI 1.82-1.89), diabetes (OR 1.31 CI 1.28-1.34), depression (OR 1.43 CI 1.39-1.47), dyslipidemia (OR 1.31 CI 1.28-1.34) elevated LDL-C (OR 1.31 CI 1.29 1.33) and depressed HDL-C (OR 1.31 CI 1.28-1.34) significantly (p