title: Economic considerations in managing patients with chronic stable angina.
abstract: OBJECTIVE
  To quantify the economic burden of chronic stable angina in the United States, characterize recent trends in the use of coronary revascularization, and compare the clinical outcomes and long-term costs of percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), and medical management in patients with stable angina.
  
  
  CONCLUSIONS
  The direct and indirect costs of stable angina are measured in tens of billions of dollars in the United States, with hospitalization contributing a large amount to the costs. The use of coronary revascularization, particularly PCI and insertion of coronary stents, has increased dramatically in recent years. The long-term costs of PCI and CABG are similar and high. Revascularization is sometimes used without an adequate trial of medical management, despite higher costs and a lack of evidence of long-term clinical benefits from revascularization.
  
  
  CONCLUSIONS
  Chronic stable angina is a costly condition. Medical management should be used before considering costly revascularization, unless medical management is contraindicated.
authors.affiliation: University of Illinois at Chicago, College of Pharmacy & Medical Center, 833 South Wood St., MC 886, Rm. 164, Chicago, IL 60612, USA. enutescu@uic.edu
authors.forename: Edith A
authors.initials: EA
authors.lastname: Nutescu
mesh_terms: D060050:Angina, Stable / Q000191:economics / Q000628:therapy*; D002908:Chronic Disease; D001026:Coronary Artery Bypass / Q000191:economics / Q000379:methods*; D054855:Drug-Eluting Stents / Q000191:economics; D017048:Health Care Costs; D006760:Hospitalization / Q000191:economics; D006801:Humans; D062645:Percutaneous Coronary Intervention / Q000191:economics / Q000379:methods*; D016896:Treatment Outcome; D014481:United States