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. 2019 Jan 8;8(1):e010376. doi: 10.1161/JAHA.118.010376

Table 1.

Definitions for Patient Characteristics

Characteristics Definition
Preindex statin fill characteristics*
 MI hospitalization16 An inpatient claim with an ICD‐9‐CM code of 410.xx (except 410.x2, which represents a subsequent episode of care) in any discharge diagnosis position
History of CHD17, 18 Any of the following:

  • ≥1 hospitalization or physician evaluation and management visit with a diagnosis code of MI (ICD‐9‐CM diagnosis code of 410.xx or 412.xx) in any discharge diagnosis position

  • ≥1 hospitalization or physician visit with a procedure code for revascularization (ICD‐9‐CM procedure codes 00.66, 36.0, 36.01–36.19, 36.2; ICD‐9‐CM diagnosis codes V45.81 or V45.82; or CPT codes 33510–33519, 33521–33523, 33530, 33533–33536, 92980–92982, 92984, 92995, 92996)

  • ≥1 inpatient or physician evaluation and management visit with another CHD‐related code (ICD‐9‐CM code of 411.xx, 413.xx, or 414.xx)
History of DM19 Any of the following:

  • ≥1 hospitalization with a discharge diagnosis code of DM (ICD‐9‐CM diagnosis codes 250.xx, 357.2, 362.0x, or 366.41) in any discharge diagnosis position

  • ≥2 physician evaluation and management visits with a diagnosis code of DM (ICD‐9‐CM diagnosis codes 250.xx, 357.2, 362.0x, or 366.41) in any position occurring at least 7 d apart

  • ≥1 pharmacy for an oral hypoglycemic medication or insulin
History of stroke20 Any of the following:

  • ≥1 hospitalization with a discharge diagnosis code of stroke (ICD‐9‐CM discharge diagnosis code of 430.xx, 431.xx, 433.x1, 434.x1 or 436.x) in any discharge diagnosis position

  • ≥1 physician evaluation and management visit with a diagnosis code of stroke (ICD‐9‐CM discharge diagnosis code of 430.xx, 431.xx, 433.x1, 434.x1 or 436.x) in any position
History of peripheral artery disease21, 22 Any of the following:

  • ≥1 hospitalization with a discharge diagnosis code of atherosclerosis or thrombosis of arteries of the extremities (ICD‐9‐CM diagnosis code of 440.20–440.24, 440.31, 444.2x, 443.9, or 444.81) in any discharge diagnosis position

  • ≥2 physician evaluation and management visits with a diagnosis code of atherosclerosis or thrombosis of arteries of the extremities (ICD‐9‐CM diagnosis code of 440.20–440.24, 440.31, 444.2x, 443.9, or 444.81) in any position on separate days

  • ≥1 hospitalization or physician visit with a CPT code 37205 or 75962
History of HF23 Any of the following:

  • ≥1 hospitalization with a discharge diagnosis code of HF (ICD‐9‐CM diagnosis code of 402.01, 402.11, 402.91, 404.01, 404.03, 404.11, 404.13, 404.91, 404.93, or 428.x) in any discharge diagnosis position

  • ≥2 physician evaluation and management visits with a diagnosis code of HF (ICD‐9‐CM diagnosis code of 402.01, 402.11, 402.91, 404.01, 404.03, 404.11, 404.13, 404.91, 404.93, or 428.x) in any position on separate days
History of CKD24, 25 Any of the following:

  • ≥1 hospitalization with a discharge diagnosis code of CKD (ICD‐9‐CM diagnosis code of 016.0, 095.4, 189.0, 189.9, 223.0, 236.91, 250.4, 271.4, 274.1, 283.11, 403.x1, 403.x0, 404.x2, 404.x3, 404.x0, 404.x1, 440.1, 442.1, 447.3, 572.4, 580–588, 591, 642.1, 646.2, 753.12–753.17, 753.19, 753.2, or 794.4) in any discharge diagnosis position

  • ≥1 physician evaluation and management visit with a diagnosis code of CKD (ICD‐9‐CM diagnosis code of 016.0, 095.4, 189.0, 189.9, 223.0, 236.91, 250.4, 271.4, 274.1, 283.11, 403.x1, 403.x0, 404.x2, 404.x3, 404.x0, 404.x1, 440.1, 442.1, 447.3, 572.4, 580–588, 591, 642.1, 646.2, 753.12–753.17, 753.19, 753.2, or 794.4) in any position
History of dementia26 Any of the following:

  • ≥1 hospitalization with a discharge diagnosis code of dementia (ICD‐9‐CM diagnosis code of 331.0, 331.1, 331.2, 331.7, 290.0, 290.1, 290.11, 290.12, 290.13, 290.20, 290.21, 290.3, 290.40, 290.41, 290.42, 290.43, 294.0, 294.1, 294.8, or 797) in any discharge diagnosis position

  • ≥1 physician evaluation and management visit with a diagnosis code of dementia (ICD‐9‐CM diagnosis code of 331.0, 331.1, 331.2, 331.7, 290.0, 290.1, 290.11, 290.12, 290.13, 290.20, 290.21, 290.3, 290.40, 290.41, 290.42, 290.43, 294.0, 294.1, 294.8, or 797) in any position
Depression23, 27, 28 Any of the following:

  • ≥1 hospitalization or physician evaluation and management visit with a diagnosis code of depression (ICD‐9‐CM diagnosis code of 296.20–296.26, 296.30–296.36, 296.51–296.56, 296.60–296.66, 296.89, 298.0, 300.4, 309.1 or 311) in any discharge diagnosis position

  • ≥1 pharmacy fill for an antidepressant defined by generic name: amitriptyline, amoxapine, bupropion, citalopram, clomipramine, desipramine, desvenlafaxine, doxepin, duloxetine, escitalopram, fluoxetine, fluvoxamine, imipramine, isocarboxazid, levomilnacipran, maprotiline, milnacipran, mirtazapine, nefazodone, nortriptyline, paroxetine, perphenazine, phenelzine, protriptyline, selegiline, sertraline, tranylcypromine, trazodone, trimipramine or venlafaxine
Postindex statin fill characteristics†
New diagnosis of CHD18, 29 Any of the following among beneficiaries without a history of CHD:

  • ≥1 hospitalization or physician evaluation and management visit with a diagnosis code of MI (ICD‐9‐CM diagnosis code of 410.xx or 412.xx) in any discharge diagnosis position

  • ≥1 hospitalization or physician visit with a procedure code for revascularization (ICD‐9‐CM procedure codes 00.66, 36.0, 36.01–36.19, 36.2; ICD‐9‐CM diagnosis codes V45.81 or V45.82; or CPT codes 33510–33519, 33521–33523, 33530, 33533–33536, 92980–92982, 92984, 92995, 92996)

  • ≥1 inpatient or physician evaluation and management visit with another CHD‐related code (ICD‐9‐CM code of 411.xx, 413.xx, or 414.xx)
New diagnosis of DM19 Any of the following among beneficiaries without a history of DM:

  • ≥1 hospitalization with a discharge diagnosis code of DM (ICD‐9‐CM diagnosis codes 250.xx, 357.2, 362.0x, or 366.41) in any discharge diagnosis position

  • ≥2 physician evaluation and management visits with a diagnosis code of DM (ICD‐9‐CM diagnosis codes 250.xx, 357.2, 362.0x, or 366.41) in any position occurring at least 7 d apart

  • ≥1 pharmacy for an oral hypoglycemic medicine or insulin
New diagnosis of stroke20 Any of the following among beneficiaries without a history of stroke:

  • ≥1 hospitalization with a discharge diagnosis code of stroke (ICD‐9‐CM discharge diagnosis code of 430.xx, 431.xx, 433.x1, 434.x1 or 436.x) in any discharge diagnosis position

  • ≥1 physician evaluation and management visit with a diagnosis code of stroke (ICD‐9‐CM discharge diagnosis code of 430.xx, 431.xx, 433.x1, 434.x1 or 436.x) in any position
New diagnosis of HF23 Any of the following among beneficiaries without a history of HF:

  • ≥1 hospitalization with a discharge diagnosis code of HF (ICD‐9‐CM diagnosis code of 402.01, 402.11, 402.91, 404.01, 404.03, 404.11, 404.13, 404.91, 404.93, or 428.x) in any discharge diagnosis position

  • ≥2 physician evaluation and management visits with a diagnosis code of HF (ICD‐9‐CM diagnosis code of 402.01, 402.11, 402.91, 404.01, 404.03, 404.11, 404.13, 404.91, 404.93, or 428.x) in any position on separate days
New diagnosis of CKD24, 25 Any of the following among beneficiaries without a history of CKD:

  • ≥1 hospitalization with a discharge diagnosis code of CKD (ICD‐9‐CM diagnosis code of 016.0, 095.4, 189.0, 189.9, 223.0, 236.91, 250.4, 271.4, 274.1, 283.11, 403.x1, 403.x0, 404.x2, 404.x3, 404.x0, 404.x1, 440.1, 442.1, 447.3, 572.4, 580–588, 591, 642.1, 646.2, 753.12–753.17, 753.19, 753.2, or 794.4) in any discharge diagnosis position

  • ≥1 physician evaluation and management visit with a diagnosis code of CKD (ICD‐9‐CM diagnosis code of 016.0, 095.4, 189.0, 189.9, 223.0, 236.91, 250.4, 271.4, 274.1, 283.11, 403.x1, 403.x0, 404.x2, 404.x3, 404.x0, 404.x1, 440.1, 442.1, 447.3, 572.4, 580–588, 591, 642.1, 646.2, 753.12–753.17, 753.19, 753.2, or 794.4) in any position
New diagnosis of dementia26 Any of the following among beneficiaries without a history of dementia:

  • ≥1 hospitalization with a discharge diagnosis code of dementia (ICD‐9‐CM diagnosis code of 331.0, 331.1, 331.2, 331.7, 290.0, 290.1, 290.11, 290.12, 290.13, 290.20, 290.21, 290.3, 290.40, 290.41, 290.42, 290.43, 294.0, 294.1, 294.8, or 797) in any discharge diagnosis position

  • ≥1 physician evaluation and management visit with a diagnosis code of dementia (ICD‐9‐CM diagnosis code of 331.0, 331.1, 331.2, 331.7, 290.0, 290.1, 290.11, 290.12, 290.13, 290.20, 290.21, 290.3, 290.40, 290.41, 290.42, 290.43, 294.0, 294.1, 294.8, or 797) in any position
Cardiologist care ≥1 physician evaluation and management visit with a specialty code 06

In Medicare, physician evaluation and management visits were defined by CPT code 99024, 99058, 99429, 99499, 99201–99215, 99241–99245, 99271–99275, 99301–99337, 99341–99355, 99385–99387, or 99395–99404, or 99281–99285. In MarketScan, physician evaluation and management visits were defined by an ambulatory visit, emergency department, or nursing home encounter type. CHD indicates coronary heart disease; CKD, chronic kidney disease; CPT, Current Procedure Terminology; DM, diabetes mellitus; HF, heart failure; ICD‐9‐CM, International Classification of Diseases, Ninth Revision, Clinical Modification; MI, myocardial infarction.

*

Defined using administrative data on or within 365 days before the date of the index statin fill.

†

Defined using administrative data within 182 days after the index statin fill.