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Burden and Predictors of Chest Pain-Related Health-Care Utilization Following Percutaneous Coronary Intervention.
- Source :
-
The American journal of cardiology [Am J Cardiol] 2021 Dec 01; Vol. 160, pp. 31-39. - Publication Year :
- 2021
-
Abstract
- Chest pain (CP) has been reported in 20% to 40% of patients 1 year after percutaneous coronary intervention (PCI), though rates of post-PCI health-care utilization (HCU) for CP in nonclinical trial populations are unknown. Furthermore, the contribution of noncardiac factors - such as pulmonary, gastrointestinal, and psychological - to post-PCI CP HCU is unclear. Accordingly, the objectives of this study were to describe long-term trajectories and identify predictors of post-PCI CP-related HCU in real-world patients undergoing PCI for any indication. This retrospective cohort study included patients receiving PCI for any indication from 2003 to 2017 through a single integrated health-care system. Post-PCI CP-related HCU tracked through electronic medical records included (1) office visits, (2) emergency department (ED) visits, and (3) hospital admissions with CP or angina as the primary diagnosis. The strongest predictors of CP-related HCU were identified from >100 candidate variables. Among 6386 patients followed an average of 6.7 years after PCI, 73% received PCI for acute coronary syndrome (ACS), 19% for stable angina, and 8% for other indications. Post-PCI CP-related HCU was common with 26%, 16%, and 5% of patients having ≥1 office visits, ED visits, and hospital admissions for CP within 2 years of PCI. The following factors were significant predictors of all 3 CP outcomes: ACS presentation, documented CP >7 days prior to the index PCI, anxiety, depression, and syncope. In conclusion, CP-related HCU following PCI was common, especially within the first 2 years. The strongest predictors of CP-related HCU included coronary disease attributes and psychological factors.<br /> (Copyright © 2021 Elsevier Inc. All rights reserved.)
- Subjects :
- Acute Coronary Syndrome surgery
Aged
Aged, 80 and over
Angina Pectoris
Angina, Stable surgery
Angina, Unstable surgery
Anxiety epidemiology
Cohort Studies
Depression epidemiology
Female
Health Services statistics & numerical data
Humans
Ischemic Stroke epidemiology
Lung Diseases epidemiology
Male
Middle Aged
Non-ST Elevated Myocardial Infarction surgery
Proportional Hazards Models
Retrospective Studies
ST Elevation Myocardial Infarction surgery
Sex Factors
Chest Pain epidemiology
Emergency Service, Hospital statistics & numerical data
Hospitalization statistics & numerical data
Office Visits statistics & numerical data
Percutaneous Coronary Intervention
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1913
- Volume :
- 160
- Database :
- MEDLINE
- Journal :
- The American journal of cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 34740394
- Full Text :
- https://doi.org/10.1016/j.amjcard.2021.07.051