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Abstract: SA-PO527

Health Care Utilizations and Costs in the Year Following an Incident Major Thrombotic Cardiovascular Event (MTCVE) in Patients with and Without ESKD

Session Information

Category: Hypertension and CVD

  • 1602 Hypertension and CVD: Clinical


  • Victores, Alejandro, Merck & Co Inc, Rahway, New Jersey, United States
  • Bash, Lori D., Merck & Co Inc, Rahway, New Jersey, United States
  • Roetker, Nicholas S., Hennepin Healthcare Research Institute Chronic Disease Research Group, Minneapolis, Minnesota, United States
  • Ramey, Dena Rosen Rosen, Merck & Co Inc, Rahway, New Jersey, United States
  • Wetmore, James B., Hennepin Healthcare Research Institute Chronic Disease Research Group, Minneapolis, Minnesota, United States
  • Bonaca, Marc P., University of Colorado Anschutz Medical Campus School of Medicine, Aurora, Colorado, United States

Patients with end-stage kidney disease (ESKD) are at higheran elevated risk of major thrombotic cardiovascular events (MTCVEs) and use moresubstantial healthcare resources than compared to patients without ESKD. There is limited information on costs following MTCVEs in patients with ESKD.


Cohorts of Medicare fee-for-service beneficiaries aged ≥66 years were created using data from the US Renal Data System (USRDS) for ESKD patients receiving in-center hemodialysis (HD) and a 20% sample of Medicare claims for non-ESKD patients. We included patients experiencing a new MTCVE (myocardial infarction, ischemic stroke, venous thromboembolism, or critical limb ischemia) between 2015-2018. Adjusted all-cause healthcare resource utilization (HCRU) and cost outcomes were assessed for 1 year following the index event.


Table 1 and Figure 1 detail HCRU and costs, respectively, in the year following each type of MTCVE. Patients with ESKD had much higher rates of all-cause hospitalization than non-ESKD patients, with the largest magnitude of difference in patients with VTE. Rates of ICU admissions, inpatient days, emergency and outpatient encounters were significantly higher in ESKD patients even after demographic adjustment. Adjusted costs of care were higher in ESKD patients compared with non-ESKD patients across all encounter and MTCVE types, with some variation in costs attributable to specific encounter types.


In the year after an incident MTCVE, patients with ESKD had significantly higher all-cause HCRU and costs of care than non-ESKD patients who experienced the same type of MTCVE. These differences persisted even after adjustment.


  • Commercial Support – Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Rahway, NJ, USA