Abstract 16951: Economic Burden of Angina and Chest Pain Following Percutaneous Coronary Intervention: a Real-World Analysis of Multi-Payer US Claims
Background: While PCI has revolutionized treatment of CHD, the contemporary incidence and economic burden of post-PCI angina and chest pain are not well documented. We sought to describe the direct medical costs associated with post-PCI angina/chest pain using real-world data.
Methods: We used the multi-payer Truven Health MarketScan Commercial and Medicare Supplemental Databases to identify all patients undergoing a PCI (index event) between 2008 and 2011. We included all patients who had 12 months of continuous medical and pharmacy benefits before and after the index event. We identified outcomes of interest (angina, chest pain) using ICD-9 and CPT codes (inpatient claim with a principal diagnosis of angina or chest pain; an outpatient claim with an accompanying stress test or repeat PCI ≥ 30 days after the index PCI). Total and cardiovascular-specific costs were defined as the total paid amount on fully adjudicated claims in the first 12 months following the index PCI (2013 US$). We excluded patients with ACS from the cost analysis.
Results: The 51,756 study patients who met the study criteria, had a mean age of 61.8 years, and 72% were men. In the first year after the index PCI, 23.1% had angina or chest pain, while only 2.7% had an ACS event. Compared with patients without an event, patients with post-PCI angina/chest pain had more hospitalizations (+0.5), clinic visits (+2.5), ER visits (+0.7), radiology services (+2.4), lab services (+6.1) and outpatient prescriptions (+5.8) (all p<0.001). At one year, the incremental total medical costs for patients with angina/chest pain were $14,796 and the incremental cardiovascular-specific costs were $10,949 (Table 1).
Conclusions: Despite continued improvement in CHD outcomes, persistent or recurrent angina and chest pain remain a clinical and economic burden in the first year after PCI. Strategies to reduce post-PCI angina/chest pain could have a substantial impact on the costs and outcomes of ischemic heart disease.
Author Disclosures: D.S. Kazi: None. O. Ben-Yehuda: None. M. Bonafede: Employment; Significant; I am an employee of Truven Health Analytics, which received a research contract to conduct this study with and on behalf of Abbott Vascular. J.B. Hernandez: Employment; Significant; I am a full-time employee of Abbott Vascular. S.F. Machacz: Employment; Significant; I am a full-time employee of Abbott Vascular.. M.A. Hlatky: None.
- © 2014 by American Heart Association, Inc.