Epidemiology, Clinical Burden and Inflammatory Marker Testing in Atherosclerotic Cardiovascular Disease and Symptomatic Heart Failure in Germany: Insights from the ACHILLES Claims Data Analysis

Objective: To provide a comprehensive and descriptive characterization of the contemporary burden of atherosclerotic cardiovascular disease (ASCVD) and symptomatic heart failure (HF) in Germany using a large healthcare claims database. Specifically, the study aimed to assess the incidence of cardiovascular disease, patient characteristics and preexisting comorbidities at initial diagnosis, clinical burden, healthcare resource utilization (HCRU) and associated costs, and inflammatory marker testing to provide insights into the current management and burden of patients with newly diagnosed ASCVD and symptomatic HF in routine clinical care.

Methods: This longitudinal cohort study used anonymized claims data provided by GWQ ServicePlus, including approximately 7.8 million individuals between 2020 and 2024. Adults with incident ASCVD or symptomatic left-ventricular HF were identified using ICD-10-GM coding algorithms following a 24-month diagnosis-free baseline period. Outcomes included annual incidence rates, all-cause mortality, CV-related hospitalizations (based on main diagnosis), and CRP testing patterns as a proxy for inflammatory assessment in routine care. Incidence rates were standardized and reported per 100,000 individuals. Time-to-event outcomes were assessed using Kaplan–Meier analyses.

Results: A total of 173,327 ASCVD and 121,208 symptomatic HF patients were identified. In 2023, age- and sex-adjusted annual incidence per 100,000 individuals were 779 for ASCVD and 668 for symptomatic HF. Overall mortality in the ASCVD cohort was 3.8%, and 43.4% in symptomatic HF patients. Estimated cumulative risks of CV-related hospitalization at 12 and 24 months were 28.6% and 33.6% in ASCVD patients, and 35.5% and 44.3% in symptomatic HF patients, respectively. CRP testing during the first and second year following the initial diagnosis was observed in 39.5% and 24.4% of ASCVD patients and 40.6% and 22.9% of symptomatic HF patients, respectively. Mean testing frequencies were 0.7 and 1.0 CRP tests per person-year in the ASCVD and HF cohorts.