title: A systematic review of the economic burden of chronic angina.
abstract: BACKGROUND
  Chronic angina carries an economic burden because of symptom management, the risk of major cardiovascular events, and lost productivity. The level of these costs has not been systematically quantified.
  
  
  OBJECTIVE
  This study sought to assemble best evidence on the economic burden of chronic angina, including both the direct costs of healthcare and the indirect costs of lost productivity.
  
  
  METHODS
  Studies published in English from January 1990 to June 2003 were located via electronic and manual searches and systematically reviewed. Eligible studies included those with information on cost of illness, cost of treatment, employment status, and/or work productivity and/or limitations for a population of patients with chronic angina.
  
  
  RESULTS
  Seventeen studies assessed the healthcare cost of managing chronic angina. Cost estimates varied widely because of differing patient populations, healthcare settings, countries of origin, and year(s) of data collection. The most critical determinant of healthcare costs appeared to be the use of revascularization procedures. Twenty studies reported work limitations, 5 of which quantified productivity loss in monetary terms. Interventions for chronic angina resulted in some improvement in employment and work limitations over the short term. However, the positive effect of revascularization procedures tended to erode over the long term (3 years and beyond) in a substantial number of patients.
  
  
  CONCLUSIONS
  Chronic angina carries substantial healthcare costs caused by frequent medical visits, medications, and expensive revascularization procedures. Workplace productivity loss because of angina is also substantial, but lasting long-term improvement in work status has been difficult to achieve.
authors.affiliation: MetaWorks Inc, Medford, Massachusetts, USA.
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Reynolds
authors.forename: Diana
authors.initials: D
authors.lastname: Frame
authors.forename: Rachel
authors.initials: R
authors.lastname: Scheye
authors.forename: M Evelyn
authors.initials: ME
authors.lastname: Rose
authors.forename: Samuel
authors.initials: S
authors.lastname: George
authors.forename: Jennifer B
authors.initials: JB
authors.lastname: Watson
authors.forename: Mark A
authors.initials: MA
authors.lastname: Hlatky
mesh_terms: D000787:Angina Pectoris / Q000191:economics* / Q000209:etiology / Q000628:therapy; D002908:Chronic Disease / Q000191:economics; D017281:Cost of Illness; D004526:Efficiency; D004651:Employment / Q000191:economics / Q000706:statistics & numerical data; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D014481:United States