A new peer-reviewed study model published in the Journal of Medical Economics, suggests that thousands of heart attacks and strokes could be avoided–and millions of dollars in healthcare costs saved–by using inflammation testing to improve cardiovascular disease (CVD) risk assessment.
The study model analyzed the clinical and financial impact of adding Cleveland HeartLab’s (CHL) inflammation testing to standard cholesterol screening. Performed on a sample of the patient’s blood, CHL’s testing measures levels of inflammatory biomarkers that can signal future heart attack and stroke risk.
Researchers from CHL and MDVIP and economists from the Analysis Group developed a risk assessment, treatment and economic model to calculate the effect of adopting this approach on a typical US health plan with one million members ages 25 and older. Among the study’s key findings were the following literature based predicted outcomes over a five-year period:
- With standard cholesterol screening alone, an estimated 21,104 non-fatal heart attacks and 22,589 non-fatal ischemic strokes would occur in this population.
- Adding routine inflammation testing to standard screening for a subgroup of plan members ages 35 and older would prevent 2,039 heart attacks and 1,869 strokes, a reduction of nearly 10 percent.
- Implementing the multi-marker approach would yield cost savings of $187.7 million ($3.13 per plan member, per month), compared to standard screening.
The study model drew on medical literature, an analysis of pharmacy claims data (for costs of preventative treatments), and real-world treatment success rates achieved by patients enrolled in MDVIP’s wellness program.
A More Accurate Way to Predict Cardiovascular Disease Risk
CVD claims more lives than all forms of cancer combined, killing 2,150 Americans every day, one every 40 seconds, often from heart attacks or strokes, according to the American Heart Association (AHA).
“This study shows that by more accurately measuring CVD risk with tools that detect arterial inflammation, we can decrease the overall number of heart attacks and strokes, allowing clinicians and health plans to deploy resources more strategically in order to better manage patient outcomes and costs,” said study author Marc Penn, MD, PhD, FACC, Director of Research at Summa Cardiovascular Institute and Chief Medical Officer of CHL.
“Even small reductions in heart attacks and strokes lead to enormous cost savings because these events are so traumatic and so costly to treat,” added Dr. Penn. Indeed, about 15 percent ($450 billion) of the $3.8 trillion spent on healthcare in the US annually is used for heart attacks and stroke treatment.
50% of Heart Attacks and Strokes Occur in People with Normal Cholesterol
Traditionally, physicians have used standard lipid tests to identify and treat people at high risk for developing CVD. However, this strategy can miss many at-risk patients. In fact, a number of studies have found that about half of all patients who suffer heart attacks and strokes have “normal” cholesterol levels.
“Inflammation has been proven to identify hidden risk in real-world clinical practice giving us a more complete picture of risk beyond our current arsenal of diagnostic tools,” said study co-author Andrea Klemes, DO, FACE, Chief Medical Officer, MDVIP.
“MDVIP physicians routinely use CHL’s inflammation testing and, as a result, are identifying more patients at risk in clinical practice,” added Dr. Klemes. “It’s also exciting to think about the impact of these results extrapolated to a larger population.”
3 Warning Signs of Hidden Heart Attack and Stroke Risk
Multi-marker inflammation testing can detect 37 to 43 percent more at-risk patients than would have been identified through checking levels of LDL (bad) cholesterol alone, a 2013 study by Drs. Penn and Klemes found. The research, which included more than 95,000 patients, was published in Future Cardiology.
In both the 2013 study and the new one, the inflammation testing included the use of measured blood levels of these three biomarkers:
- Myeloperoxidase (MPO). This immune system enzyme is released when the arterial wall is damaged or inflamed. High levels of MPO can predict heart disease risk in seemingly healthy people and are associated with more than double the risk of death from CV causes.
- Lp-PLA2. This blood -vessel enzyme, if elevated, warns of vulnerable plaque in the arteries that could erupt like a volcano and ignite a heart attack. Having normal blood pressure, but high Lp-PLA2, doubles stroke risk, while high blood pressure and high Lp-PLA2 raises risk sevenfold.
- High-sensitivity C-reactive protein (hsCRP). This protein, produced in the liver, rises when there’s inflammation in the body. Apparently healthy people with high levels of hsCRP are up to four times more likely to have heart disease. Treating patients with elevated CRP, but normal lipid levels, with statin medications can significantly reduce risk for heart attack, stroke and cardiovascular mortality.