Utilization Of Therapies In Patients Research Articles

Impact of Pretreatment Weight Loss on Radiotherapy Utilization and Clinical Outcomes in Non-Small Cell Lung Cancer.

Cancer cachexia is a syndrome of unintentional weight loss resulting in progressive functional impairment. Knowledge of radiation therapy utilization in patients with cancer cachexia is limited. We evaluated the use of curative and palliative-intent radiation for the management of patients with non-small cell lung cancer (NSCLC) with cachexia to determine whether tumor-directed therapy affected cachexia-associated outcomes. Using an Institutional Tumor Registry, we evaluated all patients with stages of NSCLC treated at a tertiary care system from 2006 to 2013. We adopted the international consensus definition for cachexia, with staging designated by the registry and positron emission tomography. Radiotherapy delivery and intent were retrospectively assessed. In total, 1330 patients with NSCLC were analyzed. Curative-intent radiotherapy was utilized equally between patients with cachexia and non-cachexia with stages I to III NSCLC. Conversely, significantly more patients with stage IV disease and cachexia received palliative radiotherapy versus those without (74% vs 63%, P = 0.006). Cachexia-associated survival was unchanged irrespective of tumor-directed radiation therapy with curative or palliative intent. In fact, pretreatment cachexia was associated with reduced survival for patients with stage III NSCLC receiving curative-intent radiotherapy (median survival = 23.9 vs 15.0 mo, P = 0.009). Finally, multivariate analysis identified pretreatment cachexia as an independent variable associated with worsened survival (hazard ratio = 1.31, CI: 1.14,1.52). Patients with advanced NSCLC with cachexia received more palliative-intent radiation than those without weight loss. Tumor-directed therapy in either a curative or palliative approach failed to alter cachexia patient survival across all stages of the disease. These findings offer critical information on the appropriate utilization of radiation in the management of patients with NSCLC with cachexia.

Optimizing Drug Delivery Systems for Enhanced Therapeutic Efficacy in Cancer Treatment: A Multidisciplinary Approach

This research aims to develop an early detection method for breast cancer through the analysis of specific biomarkers. The method leverages advanced drug delivery technology to enhance the efficacy of cancer therapy. Employing a multidisciplinary approach, this study integrates medical and pharmaceutical sciences to achieve optimal results. Specific biomarkers utilized in this research will be identified to improve the sensitivity and specificity of cancer detection. The findings of this research are anticipated to make a significant contribution to enhancing early breast cancer detection capabilities and optimizing therapy utilization in patients.

Abstract P5-14-18: Socioeconomic and geographic barriers affect rates of standard of care therapy utilization in patients with hormone receptor positive, HER2 negative metastatic breast cancer

Abstract Background: It is of value to determine whether treatment disparities exist in the management of hormone receptor positive (HR+), HER2 negative (HER2-) MBC due to location, age, gender, practice type, or payment methods. The objective of this study was to evaluate prescription patterns for CDK46 inhibitors (CDKI) in the first line setting in patients with HR+ HER2- MBC at the University of Pittsburgh Medical Center (UPMC), a tertiary care academic center with a large satellite clinic network. Methods: Data were obtained using a quality care insight tool (QCIT, Pfizer) which provided information regarding MBC treatment utilization patterns using the pharmacy and medical claims data from the IQVIA Anonymized Patient Longitudinal Dataset. This data set includes HIPAA-compliant anonymized information on diagnostic codes, tests, prescribed treatments, and procedures for 17.9 million US cancer patients from 2012 onward. Analysis was focused on a comparison of a UPMC patient cohort to a national cohort of patients with HR+/HER2- MBC to better understand local prescription patterns. Inferential statistical analysis was not applicable to data obtained from the QCIT tool and thus was not performed. Inclusion criteria included (1) patients ≥ 18 years of age on first breast cancer occurrence; (2) medical claim indicating HR+ breast cancer and the absence of HER2 positivity; and/or (3) a pharmacy claim for a CDKI; and (4) at least one medical or pharmacy claim six months before and six months after MBC diagnosis and CDKI prescription. Results: Comparison of national treatment prescription patterns to treatments utilized at UPMC facilities for patients with HR+ HER2- MBC in the first-line setting demonstrated higher rates of CDKI-based therapy utilization within UPMC institutions comparatively (61% vs. 54%, respectively). Rates of chemotherapy use in the UPMC population were concordantly lower than the national average (1% vs. 5%). The rate of CDKI-based therapy utilization in MBC patients in the first line was higher at urban UPMC sites vs. their rural counterparts (82% vs. 70%). Patients with Medicare showed notably lower CDKI utilization rates compared to their counterparts receiving Medicaid (43% vs 83%) or commercial third-party insurance (43% vs. 63%). Conclusions: Higher rates of CDKI utilization in the first-line metastatic setting indicate more widespread adoption of first line CDKI at UPMC (a tertiary health care system with a large community satellite network) as compared to national averages. Within the UPMC patient population, lower rates of first line CDKI utilization in patients receiving Medicare or in rural areas may be reflective of socioeconomic obstacles, which limit patient access to care. Further research is planned to investigate possible clinical or social determinants of these differences. Citation Format: Christopher DeHaven, Azadeh Nasrazadani, Adam Brufsky. Socioeconomic and geographic barriers affect rates of standard of care therapy utilization in patients with hormone receptor positive, HER2 negative metastatic breast cancer [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P5-14-18.

Real-world frequency of BRAF testing and utilization of therapies in patients with advanced melanoma.

Both BRAF/MEK targeted agents and immunotherapy are approved for the treatment of advanced melanoma. BRAF testing is recommended at the time of advanced melanoma diagnosis. In addition, little is known regarding the treatment trends for patients with BRAF mutated tumors. This investigation aims to assess the real-world prevalence of molecular testing and treatment trends for patients with BRAF mutated tumors. Using a de-identified database, patients of age ≥18 years with advanced melanoma from 2013 to 2018 were examined. Molecular testing performed within 3 months of advanced diagnosis was considered to have the test performed at the time of diagnosis. Test prevalence was calculated and compared in groups stratified by the patient, tumor and treatment factors. In total 4459 patients were included; 1936 (43.4%) stage III, 1191 (26.7%) stage IV and 1332 (29.9%) recurrent. Totally 50.4% of patients received systemic treatment; 76.4% stage IV, 71% recurrent patients and 26.7% stage III patients. However, 73.5% received first-line immunotherapy. In total 73.8% of patients had molecular testing, and 50.5% had tested at the time of advanced diagnosis. Of those tested 42% had a BRAF mutated tumor. In total 48% of these patients received first-line immunotherapy whereas 43% received a BRAF inhibitor, with increasing immunotherapy use seen over time. The majority of patients with advanced melanoma undergo molecular testing at the time of advanced diagnosis. Immunotherapy is the most commonly prescribed treatment regardless of BRAF mutational status. These results provide real-world data on the frequency of molecular testing and treatment trends for patients with advanced melanoma.

Abstract 9414: Utilization of Antithrombotic Therapies in Patients With Atrial Fibrillation Across the Spectrum of Stroke Risk

Introduction: OAC are recommended for AF patients with CHA 2 DS 2 -VASc ≥2 in men or ≥3 in women (high-risk group), may be considered in patients with CHA 2 DS 2 -VASc 1 in men or 2 in women (medium-risk group), and are reasonable to omit in patients with CHA 2 DS 2 -VASc 0 in men or 1 in women (low-risk group). Furthermore, NOACs are recommended over warfarin in most AF patients. This study aimed to investigate AF stroke prevention treatment patterns in patients managed in routine practice, in particular, the under-use of OAC in the high-risk group and over-use in the low-risk group. Methods: Adult patients with AF were identified using de-identified claims for commercial and Medicare Advantage enrollees in the OptumLabs Data Warehouse. Prescription fills were assessed within 90 days of a patient’s AF encounter between 1/1/2016-12/31/2020. Patients with other indications for OAC, such as VTE, recent joint replacement, prior mechanical or bioprosthetic valve replacement, rheumatic mitral stenosis, and patients who underwent LAAO were excluded. Results: Among the 339,197 AF patients, 4.4%, 8.0%, and 87.6% were in the low-, medium-, and high-risk groups, respectively. The mean age was 51.2 ±10.5 yr, 59.9 ±9.4 yr, and 75.1 ±8.8 yr. In the low-risk group, 29.6% were treated with OAC, whereas in the high-risk group, 40.3% were not treated with any antithrombotic therapy and 7.5% used thienopyridine only. Although 71% of patients on OAC were on a NOAC, the proportion of patients on NOAC decreased from 91% in the low-risk group to 69% in the high-risk group. Conclusions: There are potentially both under-use of guideline-recommended stroke prevention therapies in the high-risk patients and over-use in the low-risk group. Because patients at a high risk of stroke are also at a high risk of major and intracranial bleeding who might benefit from NOACs, the decreased use of NOAC in high-risk patients might highlight the need for future quality improvement efforts.

Rehabilitation Therapy Utilization in Patients with Parkinson's Disease in Korea.

Objective Although evidence and guidelines recommend appropriate rehabilitation from the beginning of diagnosis in patients with Parkinson's disease (PD), there is a lack of data addressing the utilization of rehabilitation therapies for these patients in practice. The aim of this study is to investigate the rate of rehabilitation therapy utilization over time in patients with PD using a nationwide cohort in Korea. Methods Patients were identified using the registration code for PD in the program for rare, intractable disease from the National Health Insurance Service-National Sample Cohort database, which consists of 979,390 Korean residents. Data were divided into four periods: 2004–2006, 2007–2009, 2010–2012, and 2013–2015. We assessed the utilization of rehabilitation therapies and the associated patient characteristics. Results The numbers of patients with PD were 384 in 2004, 855 in 2007, 1,023 in 2010, and 1,222 in 2013. The numbers of physiatrist visits per person were 0.58, 0.96, 1.97, and 2.91, in the respective periods. Among the patients, 35–40% had claims for physical therapy, 16–19% for occupational therapy, and 4–6% for swallowing therapy. There were no remarkable differences between these rates between the study periods. Sex, age, income, disability, and levodopa-equivalent dose were significantly associated with the utilization of rehabilitation therapy. Conclusion This study demonstrated that the rate of rehabilitation therapy utilization did not change remarkably in patients with PD from 2004 to 2015 in Korea although the number of physiatrist visits increased dramatically. The present evidence and guidelines may have not been adequately integrated into clinical practice during the period of study. Additional efforts may be warranted to provide adequate rehabilitation therapies in clinical practice for patients with PD.

Biologic Therapy Utilization in Patients With Moderate to Severe Psoriasis and Psoriatic Arthritis: An Observational Summary of Biologic Therapy Use in a Clinical Setting.

Plaque psoriasis affects approximately 2% to 3% of the global population, with psoriatic arthritis observed in approximately 20% to 30% of these individuals. Upon advances in research pathophysiology and treatment over the past decade, biologic therapies have been used more to treat moderate to severe psoriasis. In Canada, reimbursement bodies have defined prior authorization criteria to determine patient eligibility for funding of biologic treatments in moderate to severe plaque psoriasis. Generally, patients will have been treated with conventional therapies such as topical steroids, phototherapy, or systemic treatments such as methotrexate and cyclosporine before starting a biologic therapy. In difficult cases or severe flares in otherwise controlled disease, practitioners may augment the regimen with one or more conventional treatments. The objective of this observational report was to identify treatment pathways for psoriasis and psoriatic arthritis patients in Canada by examining initial biologic treatment and subsequent treatment optimization patterns for informed reimbursement discussions and decisions. A retrospective chart review was conducted at Newlab Clinical Research using medical records of patients who received at least 1 of 4 biologic agents approved at that time of the survey in Canada for the treatment of plaque psoriasis (adalimumab, etanercept, infliximab, ustekinumab). The study population consisted of patients who had moderate to severe plaque psoriasis, diagnosed by a dermatologist, for at least 6 months before the study index date and who attended Newlab Clinical Research between 2008 and 2013. All current and previous agents prescribed for the treatment of psoriasis were captured. A total of 248 patients with psoriasis treated with biologics were identified, of whom 27 (10.9%) were also diagnosed with psoriatic arthritis. Prior to initiating treatment with a biologic, most patients (72.1%) were treated with (or contraindicated to) methotrexate/cyclosporine. Treatment was supplemented with topical agents (70.6%) and/or followed by a course of ultraviolet light phototherapy (51.6%). Only 2.4% of patients were treated with a biologic first. Of 248 patients treated with biologics, almost half (47.6%) needed add-on therapy, whereas 16.5% of patients had an increase in dose or dosing interval. Furthermore, 14.1% of patients added a topical agent, 10.5% a topical steroid, or 6.5% a course of phototherapy while continuing biologic therapies. Finally, 30.4% of patients switched to another biologic treatment. Adalimumab was the most common agent used as a second-line agent (37.2%), and patients who started on adalimumab mainly switched to ustekinumab as a second-line agent (73.9%). Infliximab was the agent least often used as second-line therapy.

Clinicopathologic Features and Radiation Therapy Utilization in Patients with Male Breast Cancer: A National Cancer Database Study.

Male breast cancer (MBC) accounts for approximately 1% of all breast cancers, limiting the data characterizing clinicopathologic features and treatment outcomes in patients with MBC. This paucity of data has led to most of our treatment guidance being extrapolated from patients with female breast cancer (FBC). From 1998 to 2012, data were captured using the National Cancer Database to identify patients with nonmetastatic MBC (n = 23 305) and FBC (n = 2 678 061). Tumor and clinicopathologic features were obtained and compared. Patients with MBC were more likely to have invasive disease, T2-4 tumors, centrally located tumors, positive lymph nodes, estrogen receptor–positive or progesterone receptor–positive tumors, lymphovascular space invasion, and were less likely to have Her2/neu-positive or triple-negative tumors. All of these differences were statistically significant (P < .001). Treatment comparisons showed that patients with MBC were more likely to undergo mastectomy and less likely to undergo breast-conserving surgery with postoperative radiation utilization found to be less in patients with MBC, both as part of breast-conserving therapy (BCT) and for postmastectomy radiation treatment (PMRT) (P < .001). Stage-by-stage comparisons showed that median survival, 5-year, and 10-year overall survival (OS) rates are lower in patients with MBC vs patients with FBC (P < .001). The utilization of adjuvant radiation, both BCT and PMRT, was shown to improve 5- and 10-year OS (P < .001). Male breast cancer clinicopathologic features appear to be unfavorable in relation to FBC and adjuvant radiation is shown beneficial in survival outcomes. Further investigation is needed to help guide future utilization and treatment with radiation, systemic, and endocrine manipulation in this small population of patients with MBC.

Abstract P6-19-02: Clinicopathologic features and radiation therapy utilization in patients with male breast cancer: A national cancer database (NCDB) study

Abstract Introduction: Male breast cancer (MBC) is an uncommon malignancy, accounting for approximately 1% of all breast cancers (BC). The purpose of this study was to compare the clinicopathologic features of and radiation therapy (RT) utilization by patient age in patients with non-metastatic MBC and female breast cancer (FBC) using a large national database. Methods: The NCDB is a comprehensive national database that captures approximately 70% of newly diagnosed cancer patients in the US. Data for patients meeting study criteria were extracted including patient demographics, tumor characteristics, treatment modalities used, and overall survival (OS). Comparison of clinicopathologic factors between MBC and FBC were made using the Chi-Square test. Overall survival curves were estimated using Kaplan-Meier method. All results are presented as MBC vs FBC patients. Results: A total of 23,305 MBC patients and 2,678,061 FBC patients with non-metastatic breast cancer were identified in the NCDB database. The median patient age was 65 vs 60 yrs (MBC vs FBC, p &amp;lt; 0.001). Median tumor size was 19mm vs 15 mm (p &amp;lt; 0.001). In patients who had a LN evaluation, the median number of LN examined was 4 vs 3 and the median number of positive LN's were 1 vs 0. Percentage of patients undergoing breast conserving surgery was 25.6% vs 54.8%. Central tumor location was most common in MBC (30.3% vs 6.3%) and UOQ location was most common in FBC (17.2% VS 33.6%). The pathologic tumor characteristics for patients with MBC and FBC is shown in Table 1. Invasive lobular histology was less common in MBC patients (3.1% vs 7.5%). Higher percentage of female patients had non-invasive and Grade I cancers. MBC patients were more likely to have ER or PR positive tumors and less likely to have triple negative tumors. Lymph vascular invasion (LVI) was more likely to be present in MBC patients. There was a tendency towards earlier stage tumors in female patients. Regardless of gender, postoperative RT use was lower in patients 70 years or older compared to younger patients. Doing a stage-by-stage comparison, median survival was lower for patients with MBC compared to FBC. Conclusion: MBC is an uncommon malignancy accounting for approximately 1% of all breast cancers. Compared to FBC, patients with MBC presented with more advanced stage BC, and were more likely to have LVI. Median survival rates were lower for patients with MBC compared to FBC. MBCFBCp-valueBehaviorInvasive86.5%80.3%&amp;lt; 0.001GradeII13.7%18.1%&amp;lt; 0.001 II41.535.5 III/undif30/0.9%29.6/1.3% ER or PR positive 92.2%81.6%&amp;lt; 0.001Her2/neu positive 11.6%14.6%&amp;lt; 0.001Triple Negative 5.3%12.9%&amp;lt; 0.001LVIPresent27.7%16.6%&amp;lt;0.001Tumor StageTis11.1%16.4%&amp;lt; 0.001 T141.547.3 T228.119.7 Nodal StageNx17.0%18.1%&amp;lt; 0.001 N053.861.0 N121.115.8 N25.73.5 Stage Grouping010.5%16.9%&amp;lt; 0.001 I35.848.7 II39.426.6 III14.37.8 RT after BCSAll patients60.4%73.5%&amp;lt; 0.001RT after MastectomyT34 N12344.9%45.6% Older RT after BCSAll patients51.6%63.1%&amp;lt; 0.001Older RT after MastectomyT34 N12340.1%31.9%&amp;lt; 0.001Median OS (Mo)Stage 0 / I180 / 168NR / 189&amp;lt; 0.001 Stage II / III120 / 78180 / 98&amp;lt; 0.001Older - 70 years or greater; NR - Not reached Citation Format: Algan O, Herman T. Clinicopathologic features and radiation therapy utilization in patients with male breast cancer: A national cancer database (NCDB) study. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P6-19-02.

Abstract 17434: National Variation in Post-tavr Antithrombotic Therapy Utilization in Patients With Atrial Fibrillation: Insights From the Sts/acc Tvt Registry®

Background: Oral anticoagulant and antiplatelet medications are routinely prescribed for patients with pre-operative atrial fibrillation (AF) after TAVR, however, there are no data on the optimal treatment strategy, or the patterns of medication use for these patients in the United States. Methods: Using the STS/ACC TVT Registry we evaluated patients with atrial fibrillation undergoing TAVR from 2011-2014. Clinical outcomes included death, bleeding, and stroke at 1 year of follow up. Results: Of the 10,514 patients in the TVT registry during this time period, 4540 patients (43%) had pre-existing AF. Of these, 52% (n=2348) of patients were discharged with an OAC (2226 on warfarin, 122 on dabigatran) and 48% (n=2192) of patients were discharged without an OAC, with substantial unadjusted hospital level variation (Figure). Patients discharged on OAC had concomitant ASA monotherapy most frequently (1461; 62%), but dual antiplatelet therapy (DAPT)(405; 17%), clopidogrel monotherapy (224; 9.5%), and no additional therapy (258; 11%) were also used. Patients discharged without OAC were most frequently discharged on DAPT (1401; 64%), though monotherapy (680; 31%), and no antiplatelet therapy (111; 5%) were also prescribed. Patients discharged on OAC compared with those not prescribed OAC were similar with respect to age (84 vs. 85 years), gender (50 vs. 49% female), and most comorbid illnesses, but had lower STS PROM risk scores (7.8 vs. 8.7), and were less likely to have renal failure (6.1 vs. 7.0%). Patients with AF undergoing TAVR had 1-year unadjusted rates of death (23.7%; 95% CI 22.3- 25.1%), bleeding (20.2%; 95% CI 18.8-21.6%), and stroke (3.8%; 95% CI 3.2-4.4%). Conclusions: Given the substantial variation in the patterns of antithrombotic therapy prescribed for US patients with AF post-TAVR and the 1-year rates of death, stroke, and bleeding observed, sustained effort is needed to determine the optimal antithrombotic medical therapy for these patients.

2256 MEDICAL EXPULSIVE THERAPY UTILIZATION IN PATIENTS PRESENTING WITH URETEROLITHIASIS

You have accessJournal of UrologyStone Disease: Evaluation & Medical Management (II)1 Apr 20132256 MEDICAL EXPULSIVE THERAPY UTILIZATION IN PATIENTS PRESENTING WITH URETEROLITHIASIS Aaron Lay, Jeffrey Leow, Benjamin Chung, and Steven Chang Aaron LayAaron Lay Boston, MA More articles by this author , Jeffrey LeowJeffrey Leow Boston, MA More articles by this author , Benjamin ChungBenjamin Chung Stanford, CA More articles by this author , and Steven ChangSteven Chang Boston, MA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2165AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Randomized controlled trials have demonstrated the efficacy of medical expulsive therapy (MET) for promoting passage of ureteral stones. Though this is well known among urologists, there has been concern regarding its utilization in the acute setting, when these patients may not be treated by urologists. We sought to measure utilization rates of MET in patients presenting with acute ureterolithiasis. METHODS We captured all patients who had a primary diagnosis of ureterolithiasis between January 1, 2003, and December 31, 2010, based on ICD-9 code 592.1 from Premier Perspective Database (Premier Inc, Charlotte, NC), a nationally representative discharge database that covers 20% of US hospital discharges. Patients who carried diagnosis of ureterolithiasis but did not undergo a surgical procedure were included in the study. Patients who received tamsulosin, nifedipine, and/or predisone were identified by hospital charge billing descriptions. Statistical analyses were performed using STATA. All statistical testing was two-sided and a p-value<0.05 was considered statistically significant. RESULTS There were 2916 patients who had a principal diagnosis of ureterolithiasis but did not undergo a surgical procedure. Patients received tamsulosin 12.4% of the time, while nifedipine use was 1.5% and steroid use was 2.8%. Tamsulosin was more likely used in men, in teaching hospitals, and in recent years. Tamsulosin was also more likely used in the Middle Atlantic States compared to other regions of the country. CONCLUSIONS Even though there are randomized controlled trials that have demonstrated medical expulsive therapy to increase the likelihood of stone passage and faster time to stone passage, MET is underutilized. Our analysis suggests that MET is being used more frequently in recent years, but there is still underuse in the medical community. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e925 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Aaron Lay Boston, MA More articles by this author Jeffrey Leow Boston, MA More articles by this author Benjamin Chung Stanford, CA More articles by this author Steven Chang Boston, MA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Influence of coronary angiography on the utilization of therapies in patients with acute heart failure syndromes: Findings from Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure (OPTIMIZE-HF)

Most patients hospitalized for acute heart failure syndromes (AHFS) carry a diagnosis of coronary artery disease (CAD), but coronary angiography is infrequently performed. This purpose of this study was to determine the influence of coronary angiography on use of therapeutics and early postdischarge outcomes in patients with AHFS. The Organized Program to Initiate Lifesaving Treatment in Hospitalized Patients with Heart Failure program enrolled 48,612 patients admitted with AHFS at 259 academic and community hospitals throughout the United States Inhospital treatments and outcomes were tracked in all patients and postdischarge outcomes in a prespecified 10% sample. Outcome data were prospectively collected and analyzed according to whether coronary angiography was performed during the index hospitalization and whether a patient had CAD. Overall, 8.7% of all patients underwent inhospital angiography. Among patients with CAD who underwent angiography, 27.5% underwent inhospital myocardial revascularization. At the time of discharge, patients with CAD who underwent angiography were significantly more likely to be receiving aspirin (68.9% vs 50.3%, P < .0001), statins (56.6% vs 40.6%, P < .0001), beta-blockers (78.6% vs 67.5%, P < .0001), and angiotensin-converting enzyme inhibitors (64.9% vs 51.5%, P < .0001). In patients with AHFS and CAD, the use of inhospital angiography was associated with significantly lower mortality and rehospitalization risk in the first 60 to 90 days post hospital discharge after adjustment for multiple comorbidities and patient factors: mortality (HR 0.31 [95% CI 0.14-0.70], P = .004) and death or rehospitalization (OR 0.65 [95% CI 0.50-0.86], P = .003). There were no significant differences in any of these outcomes in patients with AHFS and a nonischemic etiology based the performance of inhospital angiography. The performance of inhospital angiography on patients with AHFS and CAD is associated with an increased use of aspirin, statins, beta-blockers, angiotensin-converting enzyme (ACE) inhibitors and myocardial revascularization. This corresponded with significantly lower rates of death, rehospitalization, and death or rehospitalization at 60 to 90 days post discharge.