BACKGROUND: The acute phase of @entity453 ( @entity453 ) is dramatic and receives much attention because of its high mortality and associated treatment cost. However, the acute phase typically resolves within 30 days whereas @entity453 is a @entity102 , which most @entity1 will live with for more than a decade. We compared the clinical and economic burden of @entity453 during the acute phase (first 30 days) with that in the postacute phase (31st day through 10 years). METHODS: We included @entity1187 ( @entity1187 ) @entity1 with significant @entity453 receiving an initial cardiac catheterization at Duke University Medical Center between 1986 and 1997 with follow-up continuing through 1998. Inpatient medical costs were estimated from @entity1187 clinical trial and economic study data. Costs were adjusted to 1997 values and discounted at 3% per annum. RESULTS: Our study included 9,876 @entity1187 @entity1 (5,557 with an acute @entity583 [ @entity583 ] and 4,319 with @entity1459 [ @entity1459 ]). Acute @entity583 @entity1 had higher 30-day mortality than @entity1459 @entity1 (5.6% vs. 2.3%, P <0.001). In addition, acute @entity583 and @entity1459 @entity1 had significant 10-year unadjusted and adjusted survival differences (both P <0.001). For @entity1 who survived to 30 days, there was no difference in 10-year survival between acute @entity583 and @entity1459 @entity1 before adjustment (P = 0.472). After adjustment, however, @entity1459 @entity1 who survived to 30 days had greater survival than @entity583 @entity1 (P = 0.011). Mean 10-year discounted @entity1187 inpatient medical costs were  45,253 ( 23,510 acute phase and  21,819 postacute phase, P = 0.002). Ten year costs for @entity1459 @entity1 were  46,423 ( 21,824 acute phase and  24,599 postacute phase, P = 0.003); ten year costs for @entity583 @entity1 were  44,663 ( 24,823 acute phase and  19,840 postacute phase, P <0.001). CONCLUSIONS: We found that the clinical and economic burden of @entity453 continues long after a @entity1 's acute event has resolved and that postacute @entity453 cardiac event rates and inpatient medical costs may be higher than previously estimated. With much of all medical costs occurring in the postacute phase, the potential for effective secondary prevention therapies is substantial.

Assessing the clinical and economic burden of XXXX : 1986-1998.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity1187 :: ('MESH:D054058', 'Disease') :: ['ACS', 'acute coronary syndrome'] @entity583 :: ('MESH:D009203', 'Disease') :: ['myocardial infarction', 'MI'] @entity102 :: ('MESH:D002908', 'Disease') :: ['chronic disease'] @entity1459 :: ('MESH:D000789', 'Disease') :: ['UA', 'unstable angina'] @entity453 :: ('MESH:D003324', 'Disease') :: ['CAD', 'coronary artery disease']
@entity453 :: (MESH:D003324,Disease) :: ['coronary artery disease']
