Impact of systemic inflammation on healthcare resource utilization and cost in patients with atherosclerotic cardiovascular disease and chronic kidney disease

Systemic inflammation (SI), indicated by elevated C-reactive protein (CRP) levels, is a known risk factor for adverse cardiovascular events and mortality. The aim of this study is to investigate the economic impact associated with SI on healthcare costs and resource utilization among individuals with concomitant atherosclerotic cardiovascular disease (ASCVD) and chronic kidney disease (CKD). Utilizing Danish national health registers, the study identifies patients with incident ASCVD and CKD from 2012 to 2022 based on diagnosis codes and laboratory results. SI is defined as CRP from 2 mg/L to 20 mg/L. The increased cost and use of healthcare services associated with SI is identified by comparing individuals with SI with individuals without SI. Statistical adjustments are made for age, sex, and comorbidities to control for confounding factors. Among patients with ASCVD and CKD, the presence of SI was significantly associated with higher healthcare interactions, with an average increase of 6.7 outpatient and 7.0 more inpatient contacts over the study period compared to those without SI. Furthermore, SI is associated with a 1.4-fold increase in healthcare expenditure, resulting in an excess cost of EUR 14,370 per patient over the first 3 years of the follow-up period. The lack of a definitive onset date for SI complicates the analysis, as it is based on CRP tests conducted within 2 years of ASCVD and CKD diagnoses, potentially excluding individuals with prolonged SI prior to testing. SI is associated with higher healthcare resource utilization and costs among patients with ASCVD and CKD.