The prevalence, health care resource utilization, and clinical characteristics of individuals with atherosclerotic cardiovascular disease in Manitoba

Background: Many individuals with atherosclerotic cardiovascular disease (ASCVD) have elevated low density lipoprotein cholesterol (LDL-C) levels which increases the risk of adverse cardiovascular events such as stroke, myocardial infarction, and cardiovascular death.We conducted an observational study to report the point prevalence of ASCVD in Manitoba and to describe this population in terms of demographic, clinical characteristics, treatment received, and health care resource utilization.Methods: Our retrospective cohort study linked population-level de-identified health administrative databases.We included adults (age 18 years) with a diagnosis of ASCVD between April 1, 2006 and July 1, 2019.In a 1-year baseline period, we assessed LDL-C levels, lipid lowering therapy (LLT) prescriptions, and cardiovascular (CV) events along with their costs.Results: There were 112,601 individuals with ASCVD in Manitoba (point prevalence = 10.5%).The mean age was 68.6 14.7 years, 60,353 (53.2%) were male, and 61,124 (54.3%) were being treated with LLT.In 19,046 individuals with an LDL-C at baseline, 7,887 (41.4%) were meeting a target of <1.8 mmol/L.There were 4,619 CV events [rate = 41.28/1,000person-years (95% CI: 39.98-42.63)]and a cumulative estimated hospitalization cost of $77.8 million. Conclusion:The estimated prevalence of ASCVD among adults in Manitoba is 10.5% and 45.7% of these individuals were not being treated with LLT.In individuals with an LDL-C at baseline, 41.4% were meeting a target of <1.8 mmol/L.These results may provide inputs to inform future cost-effectiveness analyses of incorporating more novel LLT therapeutics to lower LDL-C levels in individuals with ASCVD .