title: Angina and associated healthcare costs following percutaneous coronary intervention: A real-world analysis from a multi-payer database.
abstract: OBJECTIVE
  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. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Columbia University and Cardiovascular Research Foundation, New York, New York.
authors.forename: Ori
authors.initials: O
authors.lastname: Ben-Yehuda
authors.affiliation: Department of Medicine (Cardiology), University of California, San Francisco, California.|Department of Epidemiology & Biostatistics, University of California, San Francisco, California.|Division of Cardiology, San Francisco General Hospital, San Francisco, California.
authors.forename: Dhruv S
authors.initials: DS
authors.lastname: Kazi
authors.affiliation: Truven Health Analytics, Brentwood, New Hampshire.
authors.forename: Machaon
authors.initials: M
authors.lastname: Bonafede
authors.affiliation: Wade Outcomes Research and Consulting, Salt Lake City, Utah.
authors.forename: Sally W
authors.initials: SW
authors.lastname: Wade
authors.affiliation: Health Economics and Outcomes Research, Abbott Vascular, Santa Clara, California.
authors.forename: Susanne F
authors.initials: SF
authors.lastname: Machacz
authors.affiliation: Health Economics and Outcomes Research, Abbott Vascular, Santa Clara, California.
authors.forename: Leslie A
authors.initials: LA
authors.lastname: Stephens
authors.affiliation: Stanford University School of Medicine, HRP Redwood Building, Stanford, California.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Hlatky
authors.affiliation: Health Economics and Outcomes Research, Abbott Vascular, Santa Clara, California.
authors.forename: John B
authors.initials: JB
authors.lastname: Hernandez
mesh_terms: D054058:Acute Coronary Syndrome / Q000191:economics / Q000453:epidemiology / Q000628:therapy; D000067575:Administrative Claims, Healthcare; D000368:Aged; D000553:Ambulatory Care / Q000191:economics; D000787:Angina Pectoris / Q000175:diagnosis / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D016208:Databases, Factual; D016527:Drug Costs; D005260:Female; D017048:Health Care Costs; D006295:Health Resources / Q000191:economics* / Q000706:statistics & numerical data; D017721:Hospital Costs; D006801:Humans; D015994:Incidence; D008297:Male; D006278:Medicare / Q000191:economics; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000191:economics*; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
keywords: coronary artery disease; economics/cost-effectiveness; health care outcomes; percutaneous coronary intervention