Abstract 17250: Ranolazine Use Following Initial Anti-anginal Therapy Is Associated With Lower Health Resource Utilization Among U.S. Veterans With Chronic Stable Angina
Introduction: While clinical trials show improvement in angina symptoms with ranolazine, it is unclear whether this improvement translates into reduced health resource utilization (HRU). We, therefore, sought to analyze whether HRU declined at one year after ranolazine initiation within a large integrated health system.
Methods: This was a historical cohort study using nationwide Department of Veterans Affairs (VA) data. We compared participants with a diagnosis of coronary artery disease and chronic stable angina who were prescribed ranolazine, as monotherapy or add-on, following an initial trial of ≥ 1 anti-anginal agent versus alternative secondary agents between 01/01/2006 and 12/31/2013. We addressed confounding through inverse probability (IP) of treatment weighting. We used IP-weighted regression models to evaluate adjusted risk ratios and incident rate ratios for coronary revascularizations, hospitalizations, emergency room (ER) visits, and costs within one year.
Results: Of 37,060 patients identified, IP weighted treatment groups comprised 4,766 patients prescribed ranolazine and 32,261 prescribed an alternative agent as their second or third anti-anginal. There were no significant differences in baseline characteristics between treatment groups after IP weighting. In the IP-weighted outcome analysis, coronary artery bypass graft surgeries were significantly lower with ranolazine. All-cause, atrial fibrillation (AF) and heart failure (HF) specific hospitalizations, and total costs were significantly lower in the ranolazine group.
Conclusions: Among patients with CSA prescribed a second or third anti-anginal pharmacotherapy, ranolazine was associated with fewer all-cause hospitalizations, hospitalizations for AF and HF, ER visits and total costs. These findings suggest that the reduction in angina symptoms seen in other studies of ranolazine may translate into lower HRU compared to conventional pharmacotherapies.
Author Disclosures: A. Bress: Research Grant; Significant; Gilead. J. Dodson: None. B. Sauer: None. S. DuVall: None. J. Crook: None. T. Reese: None. C. Hartsfield: Employment; Significant; Gilead Sciences. B. Koch: Employment; Significant; Gilead. R. Nelson: None. J. LaFleur: Research Grant; Significant; Gilead.
- © 2015 by American Heart Association, Inc.