Anacetrapib
In REVEAL, new stroke, heart failure or cancer each cut quality of life and add thousands in hospital costs, but MI and coronary revascularisation alone do not (J Am Heart Assoc 2023)
Original title: Impact of New Cardiovascular Events on Quality of Life and Hospital Costs in People With Cardiovascular Disease in the United Kingdom and United States
Using data from 21 820 participants in the REVEAL trial of anacetrapib in secondary cardiovascular prevention across Europe and North America, this analysis assessed how new vascular and non-vascular events over 4 years of follow-up affected quality of life (EuroQol 5-Dimension-5-Level) and hospital costs from UK and US health system perspectives. Quality of life fell in the year of the event and in subsequent years for non-haemorrhagic stroke (-0.067 UK, -0.069 US), heart failure admission (-0.072 UK, -0.103 US), incident cancer (-0.064 UK, -0.068 US) and non-coronary revascularisation (-0.071 UK, -0.061 US). Myocardial infarction and coronary revascularisation procedures alone did not measurably affect quality of life. Every adverse event added hospital costs in the year of occurrence and afterward, with the largest additional costs for non-coronary revascularisation (£5830 UK, $14 133 US) and myocardial infarction with urgent revascularisation (£5614, $24722). A health-economics analysis using the REVEAL trial population and events, not a report of anacetrapib efficacy itself.
Original abstract
Background: Despite optimized risk factor control, people with prior cardiovascular disease remain at high cardiovascular disease risk. We assess the immediate- and longer-term impacts of new vascular and nonvascular events on quality of life (QoL) and hospital costs among participants in the REVEAL (Randomized Evaluation of the Effects of Anacetrapib Through Lipid Modification) trial in secondary prevention.
Methods And Results: Data on demographic and clinical characteristics, health-related quality of life (QoL: EuroQoL 5-Dimension-5-Level), adverse events, and hospital admissions during the 4-year follow-up of the 21 820 participants recruited in Europe and North America informed assessments of the impacts of new adverse events on QoL and hospital costs from the UK and US health systems' perspectives using generalized linear regression models. Reductions in QoL were estimated in the years of event occurrence for nonhemorrhagic stroke (-0.067 [United Kingdom], -0.069 [US]), heart failure admission (-0.072 [United Kingdom], -0.103 [US]), incident cancer (-0.064 [United Kingdom], -0.068 [US]), and noncoronary revascularization (-0.071 [United Kingdom], -0.061 [US]), as well as in subsequent years following these events. Myocardial infarction and coronary revascularization (CRV) procedures were not found to affect QoL. All adverse events were associated with additional hospital costs in the years of events and in subsequent years, with the highest additional costs in the years of noncoronary revascularization (£5830 [United Kingdom], $14 133 [US Medicare]), of myocardial infarction with urgent CRV procedure (£5614, $24722), and of urgent/nonurgent CRV procedure without myocardial infarction (£4674/£4651 and $15 251/$17 539).
Conclusions: Stroke, heart failure, and noncoronary revascularization procedures substantially reduce QoL, and all cardiovascular disease events increase hospital costs. These estimates are useful in informing cost-effectiveness of interventions to reduce cardiovascular disease risk in secondary prevention.
Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01252953; https://www.Isrctn.com. Unique identifier: ISRCTN48678192; https://www.clinicaltrialsregister.eu. Unique identifier: 2010-023467-18.
anacetrapibhealth economicsoutcomes trials
Summary written by cetpinhibition.org from the published abstract; figures as published. Page updated 18 August 2026. Methods.