Daily angina after an acute coronary syndrome was associated with a >2-fold increase in cardiovascular healthcare costs compared to no angina (adjusted relative cost ratio 2.32; 95% CI 2.01-2.69).
Cohort (n=5,460)
Does higher angina frequency increase cardiovascular resource utilization and costs in stable outpatients after an acute coronary syndrome?
Higher angina frequency in stable outpatients after an acute coronary syndrome is directly associated with a graded increase in healthcare costs and resource utilization.
Effect estimate: adjusted relative cost ratio 2.32 (95% CI 2.01 to 2.69)
Absolute Event Rate: 6949% vs 2928%
p-value: p=<0.001
BACKGROUND: Angina in patients with coronary artery disease is associated with worse quality of life; however, the relationship between angina frequency and resource utilization is unknown. METHODS AND RESULTS: Using data from the MERLIN-TIMI 36 trial, we assessed the association between the extent of angina after an acute coronary syndrome (ACS) and subsequent cardiovascular resource utilization among 5460 stable outpatients who completed the Seattle Angina Questionnaire at 4 months after an ACS and who were then followed for an additional 8 months. Angina frequency was categorized as none (score, 100; 2739 patients), monthly (score, 61 to 99; 1608 patients), weekly (score, 31 to 60; 854 patients), and daily (score, 0 to 30; 259 patients). Multivariable regression models evaluated the association between angina frequency and overall costs attributable to cardiovascular hospitalizations, outpatient visits and procedures, and medications. As compared with no angina, overall costs increased in a graded fashion with higher angina frequency-no angina, 2928 (reference) ; monthly angina, 3909 (adjusted relative cost ratio, 1. 29; 95% CI, 1. 21 to 1. 39) ; weekly angina, 4558 (adjusted relative cost ratio, 1. 52; 95% CI, 1. 48 to 1. 67) ; and daily angina, 6949 (adjusted relative cost ratio, 2. 32; 95% CI, 2. 01 to 2. 69; P for trend 2-fold increase in resource utilization and incremental costs of 4000 after 8 months of follow-up.
Arnold et al. (2009) conducted a cohort in Acute Coronary Syndrome (n=5,460). Higher angina frequency (daily) vs. No angina was evaluated on Overall costs attributable to cardiovascular hospitalizations, outpatient visits and procedures, and medications (adjusted relative cost ratio 2.32, 95% CI 2.01 to 2.69, p=<0.001). Daily angina after an acute coronary syndrome was associated with a >2-fold increase in cardiovascular healthcare costs compared to no angina (adjusted relative cost ratio 2.32; 95% CI 2.01-2.69).