Cardiology and Therapy · Published 2026-08-01 · DOI 10.1007/s40119-026-00459-3
Chi Nguyen, Radha Ryali, Jeffrey R. Skaar, Wing Chow, Carey Robar, Allegra Kaufman, Weilong Li, Binita Shah
Abstract Introduction Patients with atherosclerotic cardiovascular disease (ASCVD) and systemic inflammation (SI) or chronic kidney disease (CKD) have poorer outcomes than those without SI or CKD. This study evaluated the impact of both SI and CKD on major adverse cardiovascular events (MACE), healthcare costs, and healthcare resource utilization (HCRU) in patients with ASCVD. Methods This retrospective cohort study examined the association between SI and revised MACE, healthcare costs, and HCRU among adult patients with ASCVD from the Komodo Healthcare Map®. CKD stage 3–4 was determined from claims or laboratory data. SI was defined as ≥ 1 high-sensitivity C-reactive protein (hsCRP) value of 2–10 mg/l (without SI, all hsCRP values < 2 mg/l). The primary endpoint, revised MACE, was defined as a composite of nonfatal myocardial infarction, nonfatal stroke, and all-cause mortality. Results Of 74,884 patients with ASCVD and ≥ 1 eligible hsCRP value, 8.5% had CKD stage 3–4, and 49.2% had SI. Patients with SI had a higher comorbidity index and a greater prevalence of obesity, hypertension, and type 2 diabetes than those without SI. Compared with patients with ASCVD without CKD or SI, SI alone was associated with a 24% higher risk (hazard ratio [HR] 1.24; 95% CI 1.15–1.34), CKD stage 3–4 with a 33% higher risk (HR 1.33; 95% CI 1.16–1.51), and both SI and CKD stage 3–4 with a 62% higher risk (HR 1.62; 95% CI 1.45–1.82) of revised MACE. In patients with ASCVD without CKD, total healthcare costs were $18,002 PPPY with SI vs. $15,070 PPPY without SI. In patients with ASCVD with CKD stage 3–4, costs were $26,089 PPPY with SI vs. $20,753 PPPY without SI. Across groups, SI was associated with higher HCRU. Conclusions SI is associated with increased risk of MACE and higher total healthcare costs and HCRU in patients with ASCVD with or without CKD.
Abstract from DOAJ. Public domain (CC0 1.0).
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Nguyen, C., Ryali, R., Skaar, J., et al. (2026). Real-World Analysis of the Association Between Systemic Inflammation, Cardiovascular Events, and Economic Burden Among Patients with Atherosclerotic Cardiovascular Disease and Chronic Kidney Disease. Cardiology and Therapy. https://doi.org/10.1007/s40119-026-00459-3