Abstract 11656: Ranolazine Improves Cardiovascular-and Diabetes-Related Healthcare Utilization in Patients With Chronic Stable Angina and Co-Morbid Diabetes
Introduction: Ranolazine(RAN) may improve cardiovascular (CV) and diabetes (DM) healthcare utilization and outcomes in patients with chronic stable angina (CSA) and DM.
Methods: Medical, pharmacy claims linked with laboratory data from 2008-2012 were analyzed using a commercial database. Patients with CSA receiving RAN, beta blocker (BB),calcium channel blocker (CCB), or long-acting nitrate (nitrate), along with sublingual nitroglycerin were identified and followed for 12 months after antianginal therapy change. Therapy change was defined as adding or switching to another antianginal or RAN (index date) following previous therapy. Four CSA groups were identified (BB, CCB, nitrates,RAN) and propensity matched based on baseline age, gender, chronic condition index, ACS, hypertension, DM, heart failure, hyperlipidemia, DM related complications, and CV costs. A subset of patients with DM represented the study groups. Logistic regression models were developed comparing revascularization at 30, 60, 90, 180 and 360 days between groups. Negative binomial regression was used to compare CV and DM related healthcare utilization. Descriptive differences in HbA1C levels pre and post therapy change were reported.
Results: 3724 patients were identified (BB, n=933;CCB,n=940; nitrates,n=937, RAN, n=914). Majority (61-65%) were male with a mean age of 66-67 years. Compared to other antianginals, RAN exhibited significantly lower odds for revascularization at all time periods, a lower rate for CV related outpatient and ER visits, and a reduced expected rate of DM related inpatient length of stay (Table). RAN was associated with a mean HbA1C reduction of 0.20 mg/dl compared to the BB (0.14 mg/dl increase, p=0.028), CCB (0.21 mg/dl increase, p=0.005), and nitrate (0.05 mg/dl decrease, p=0.277) cohorts.
Conclusion: RAN demonstrated lower CV and DM healthcare utilization compared to traditional antianginals, while not worsening glycemic control vs. BB and CCB.
Author Disclosures: R.L. Page: None. V. Ghushchyan: None. R.A. Allen: None. C.L. Hartsfield: Employment; Significant; Gilead Sciences. B.R. Koch: Employment; Significant; Gilead Sciences. K.V. Nair: None.
- © 2014 by American Heart Association, Inc.