1, 2, 3 Contemporary evidence‐based interventions for stable angina include aggressive lifestyle modifications, pharmacotherapy, and coronary revascularization to improve anginal symptoms and overall health status. Stable angina affects >10 million Americans and is the presenting symptom in approximately half of patients with coronary artery disease. The multivariable hazard ratio comparing CCS IV with CCS I was 1.20 (95% CI, 1.09–1.33) for all‐cause hospitalization, 1.25 (95% CI, 0.96–1.64) for acute coronary syndrome hospitalizations, 1.00 (95% CI, 0.80–1.26) for heart failure hospitalizations, 1.05 (95% CI, 0.88–1.25) for atrial fibrillation hospitalizations, 1.92 (95% CI, 1.40–2.64) for percutaneous coronary intervention, and 2.51 (95% CI, 1.99–3.16) for coronary artery bypass grafting surgery. Multivariable adjusted hazard ratios for all‐cause mortality comparing CCS II, III, and IV with those in class I were 1.05 (95% CI, 0.95–1.15), 1.33 (95% CI, 1.20–1.47), and 1.48 (95% CI, 1.25–1.76), respectively. During a median follow‐up of 3.4 years, all‐cause mortality rates were 4.58, 4.60, 6.22, and 6.83 per 100 person‐years for CCS classes I, II, III, and IV, respectively. The mean age was 66.6☙.8 years, 99% of participants were male, and 81% were white. Of 299 577 veterans identified, 14 216 (4.7%) had ≥1 CCS classification extracted by natural language processing. Outcomes included all‐cause mortality (primary), all‐cause and cardiovascular‐specific hospitalizations, coronary revascularization, and 1‐year healthcare costs. Veterans with a prior diagnosis of coronary artery disease were excluded. In this retrospective cohort study of veterans in the United States with stable angina from January 1, 2006, to December 31, 2013, natural language processing extracted CCS classifications. Stroke: Vascular and Interventional Neurology.Journal of the American Heart Association (JAHA).Circ: Cardiovascular Quality & Outcomes.Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB).
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