Original Studies Angina and Associated Healthcare Costs Following Percutaneous Coronary Intervention: A Real-World Analysis From a Multi-Payer Database Ori Ben-Yehuda, 1 * MD, Dhruv S. Kazi, 2,3,4 MD, MS, Machaon Bonafede, 5 PhD, MPH, Sally W. Wade, 6 MPH, Susanne F. Machacz, 7 MPH, Leslie A. Stephens, 7 MPH, Mark A. Hlatky, 8 MD, and John B. Hernandez, 7 PhD Objectives: To study the contemporary, real-world clinical and economic burden asso- ciated with angina after percutaneous coronary intervention (PCI). Background: An- gina adversely affects quality of life and medical costs, yet data on real-world prevalence of angina following PCI and its associated economic consequences are limited. Methods: In a multi-payer administrative claims database, we identified adults with incident inpatient PCI admissions between 2008 and 2011 who had at least 12 months of continuous medical and pharmacy benefits before and after the procedure. Patients were followed for up to 36 months. Using claims, we ascertained post-PCI outcomes: angina or chest pain, acute myocardial infarction, acute coronary syn- drome, repeat PCI, healthcare service utilization, and costs. Results: Among 51,710 study patients (mean age 61.8, 72% male), post-PCI angina or chest pain was present in 28% by 12 months and 40% by 36 months. Compared with patients who did not ex- perience chest pain, angina or ACS, total healthcare costs in the first year after the index PCI were 1.8 times greater for patients with angina or chest pain ($32,437 vs. $17,913, P < 0.001). These cost differentials continued to 36 months. Conclusions: An- gina after PCI is a frequent and expensive outcome. Further research is needed to identify risk factors and potentially improve outcomes for post-PCI angina. V C 2016 Wiley Periodicals, Inc. Key words: coronary artery disease; percutaneous coronary intervention; economics/ cost-effectiveness; health care outcomes 1 Columbia University and Cardiovascular Research Founda- tion, New York, New York 2 Department of Medicine (Cardiology), University of California, San Francisco, California 3 Department of Epidemiology & Biostatistics, University of California, San Francisco, California 4 Division of Cardiology, San Francisco General Hospital, San Francisco, California 5 Truven Health Analytics, Brentwood, New Hampshire 6 Wade Outcomes Research and Consulting, Salt Lake City, Utah 7 Health Economics and Outcomes Research, Abbott Vascular, Santa Clara, California 8 Stanford University School of Medicine, HRP Redwood Building, Stanford, California Additional Supporting Information may be found in the online ver- sion of this article. Conflict of interest: SFM, LAS, and JBH are employees of Abbott. MB is an employee of Truven Health Analytics. SW is a consultant to Truven Health Analytics. OBY is an employee of Cardiovascular Research Foundation (CRF) which has received institutional grants from Abbott Vascular. *Correspondence to: Ori Ben-Yehuda, Columbia University and Cardiovascular Research Foundation, 111 E. 59th Street, 12th Floor, New York, NY 10022. E-mail: obenyehuda@crf.org Received 9 February 2015; Revision accepted 28 November 2015 DOI: 10.1002/ccd.26365 Published online 00 Month 2016 in Wiley Online Library (wileyonlinelibrary.com) V C 2016 Wiley Periodicals, Inc. Catheterization and Cardiovascular Interventions 00:00–00 (2016)