Ori Ben-Yehuda1, Dhruv S Kazi2,3,4, Machaon Bonafede5, Sally W Wade6, Susanne F Machacz7, Leslie A Stephens7, Mark A Hlatky8, John B Hernandez7. 1. Columbia University and Cardiovascular Research Foundation, New York, New York. 2. Department of Medicine (Cardiology), University of California, San Francisco, California. 3. Department of Epidemiology & Biostatistics, University of California, San Francisco, California. 4. Division of Cardiology, San Francisco General Hospital, San Francisco, California. 5. Truven Health Analytics, Brentwood, New Hampshire. 6. Wade Outcomes Research and Consulting, Salt Lake City, Utah. 7. Health Economics and Outcomes Research, Abbott Vascular, Santa Clara, California. 8. Stanford University School of Medicine, HRP Redwood Building, Stanford, California.
Abstract
OBJECTIVES: To study the contemporary, real-world clinical and economic burden associated with angina after percutaneous coronary intervention (PCI). BACKGROUND: Angina adversely affects quality of life and medical costs, yet data on real-world prevalence of angina following PCI and its associated economic consequences are limited. METHODS: In a multi-payer administrative claims database, we identified adults with incident inpatient PCI admissions between 2008 and 2011 who had at least 12 months of continuous medical and pharmacy benefits before and after the procedure. Patients were followed for up to 36 months. Using claims, we ascertained post-PCI outcomes: angina or chest pain, acute myocardial infarction, acute coronary syndrome, repeat PCI, healthcare service utilization, and costs. RESULTS: Among 51,710 study patients (mean age 61.8, 72% male), post-PCI angina or chest pain was present in 28% by 12 months and 40% by 36 months. Compared with patients who did not experience chest pain, angina or ACS, total healthcare costs in the first year after the index PCI were 1.8 times greater for patients with angina or chest pain ($32,437 vs. $17,913, P < 0.001). These cost differentials continued to 36 months. CONCLUSIONS: Angina after PCI is a frequent and expensive outcome. Further research is needed to identify risk factors and potentially improve outcomes for post-PCI angina.
OBJECTIVES: To study the contemporary, real-world clinical and economic burden associated with angina after percutaneous coronary intervention (PCI). BACKGROUND:Angina adversely affects quality of life and medical costs, yet data on real-world prevalence of angina following PCI and its associated economic consequences are limited. METHODS: In a multi-payer administrative claims database, we identified adults with incident inpatient PCI admissions between 2008 and 2011 who had at least 12 months of continuous medical and pharmacy benefits before and after the procedure. Patients were followed for up to 36 months. Using claims, we ascertained post-PCI outcomes: angina or chest pain, acute myocardial infarction, acute coronary syndrome, repeat PCI, healthcare service utilization, and costs. RESULTS: Among 51,710 study patients (mean age 61.8, 72% male), post-PCI angina or chest pain was present in 28% by 12 months and 40% by 36 months. Compared with patients who did not experience chest pain, angina or ACS, total healthcare costs in the first year after the index PCI were 1.8 times greater for patients with angina or chest pain ($32,437 vs. $17,913, P < 0.001). These cost differentials continued to 36 months. CONCLUSIONS:Angina after PCI is a frequent and expensive outcome. Further research is needed to identify risk factors and potentially improve outcomes for post-PCI angina.
Authors: Constantin von Zur Mühlen; Simon Reiss; Axel J Krafft; Lisa Besch; Marius Menza; Manfred Zehender; Timo Heidt; Alexander Maier; Thomas Pfannebecker; Andreas Zirlik; Jochen Reinöhl; Peter Stachon; Ingo Hilgendorf; Dennis Wolf; Philipp Diehl; Tobias Wengenmayer; Ingo Ahrens; Christoph Bode; Michael Bock Journal: PLoS One Date: 2018-01-25 Impact factor: 3.240
Authors: Alexander C Fanaroff; Lisa A Kaltenbach; Eric D Peterson; Connie N Hess; David J Cohen; Gregg C Fonarow; Tracy Y Wang Journal: J Am Heart Assoc Date: 2017-10-19 Impact factor: 5.501