Background and aims: Abdominal aortic calcification (AAC) and low ankle-brachial index (ABI) are markers of multisite atherosclerosis. We sought to estimate their associations in older men with health care costs and utilization adjusted for each other, and after accounting for CVD risk factors and prevalent CVD diagnoses. Methods: This was an observational cohort study of 2393 community-dwelling men (mean age 73.6 years) enrolled in the Osteoporotic Fractures in Men (MrOS) study and U.S. Medicare Fee for Service (FFS). AAC was scored on baseline lateral lumbar spine X-rays using a 24-point scale. ABI was measured as the lowest ratio of arm to right or left ankle blood pressure. Health care costs, hospital stays, and SNF stays were identified from Medicare FFS claims over 36 months following the baseline visit. Results: Men with AAC score ≥9 (n = 519 [21.7% of analytic cohort]) had higher annualized total health care costs of $1473 (95% C.I. 293, 2654, 2017 U S. dollars) compared to those with AAC score 0–1, after multivariable adjustment. Men with ABI <0.90 (n = 154 [6.4% of analytic cohort]) had higher annualized total health care costs of $2705 (95% CI 634, 4776) compared to men with normal ABI (≥0.9 and < 1.4), after multivariable adjustment. Conclusions: High levels of AAC and low ABI in older men are associated with higher subsequent health care costs, after accounting for clinical CVD risk factors, prevalent CVD diagnoses, and each other. Further investigations of whether preventing progression of peripheral vascular disease and calcification reduces subsequent health care costs are warranted.
|Original language||English (US)|
|Number of pages||7|
|State||Published - Feb 2020|
Bibliographical noteFunding Information:
Dr. Adabag has received research grant support from the American Heart Association and Medtronic Inc . for work unrelated to this manuscript. All of the other authors have no conflicts of interest to disclose.
The Osteoporotic Fractures in Men (MrOS) Study is supported by National Institutes of Health funding. The following institutes provide support: the National Institute on Aging (NIA) , the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) , the National Center for Advancing Translational Sciences (NCATS) , and NIH Roadmap for Medical Research under the following grant numbers: U01 AG027810 , U01 AG042124 , U01 AG042139 , U01 AG042140 , U01 AG042143 , U01 AG042145 , U01 AG042168 , U01 AR066160 , and UL1 TR000128 .
The salary of Dr. Lewis is supported by a National Health and Medical Research Council (Australia) Career Development Fellowship (ID: 1107474 ).
© 2020 Elsevier B.V.
- Abdominal aortic calcification
- Ankle-brachial index
- Health care costs
- Peripheral arterial disease