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APHA Scientific Session and Event Listing

Judith Kempf, PhD¹, S.S. Shetty, PhD², Michael Nelson, PharmD², and Michael Sweeney, MD¹. (1) CV Therapeutics, 3172 Porter Drive, Palo Alto, CA 94304, 6503848447, judith.kempf@cvt.com, (2) i3Magnifi, 12125 Technology Drive, Eden Prairie, MN 55344

Background: Angina is common in Coronary Artery Disease (CAD), the leading cause of death in the US for both men and women. The American Heart Association estimates that nearly 7 million Americans suffer from angina and that 400,000 new cases are diagnosed each year.

Angina patients experience a feeling of crushing or squeezing, most often behind the breastbone. Because angina can be triggered by exercise, eating a large meal, or emotional stress, angina patients tend to limit daily activities in order to avoid an attack. The majority of angina patients (82% in one study) downsize their lifestyles to avoid angina attacks which can be both frightening and debilitating.

Given the symptoms and activity limitations experienced by angina patients, we wanted to know if angina patients have different treatment patterns and healthcare resource use compared to other CAD patients without angina.

Methods: This study looks at treatment patterns in a managed care population comparing CAD patients with and without angina. The data source is a US managed care plan covering 13 million lives. CAD patients enrolled between 2001 and 2004 for eighteen consecutive months were selected using algorithms comprised of multiple coronary artery disease ICD-9 diagnosis, procedure and drug codes. Patients were followed for 1 year to study health care treatment patterns following an episode of CAD.

Results: There were 140,011 CAD patients without angina and 25,535 with angina that met the selection criteria. One of the most notable trends for angina patients was a greater use of treatment providers. Angina patients were much more likely to have a CAD-related Emergency Department visit (OR 2.75; CI 2.64-2.81) than CAD patients without angina. Angina patients were also more likely to have a CAD-related ambulatory visit (6 versus 2.5 per year) and an inpatient visit (OR 4.72; CI 4.57-4.86) during the year.

As well, angina patients were more likely than other CAD patients to be treated with cardiovascular drugs. Nearly three quarters of angina patients used statins (71%) compared with half (50%) of CAD patients. Three quarters of angina patients used Beta-Blockers (76% vs 33%), while more angina patients used Calcium-Channel-Blockers (40% vs 16%) and ACE-inhibitors (40% vs 26%).

Conclusions: When compared to other CAD patients, patients with angina use substantially more treatment provider resources and are prescribed more medications.

Learning Objectives:

• Describe patient characteristics of angina.
• Discuss treatment patterns of angina patients.
• Indentify the burden of disease for angina patients.

Keywords: Treatment Patterns,

Presenting author's disclosure statement:

Not Answered