Data is available on stent PTCA restenosis rates in RCTs but little data is available on restenosis rates and medical costs in actual practice. OBJECTIVES: To compare restenosis rates (repeat PTCA or stent, coronary artery bypass grafting, or myocardial infarction) and medical care costs during one year post-PTCA for patients with and without stents. METHODS: A total of 1,756 patients with index PTCA during 1995 and no PTCA in the prior 1-year were identified from a medical claims database of large self-insured plans covering 1.7 million lives. Stents were received by 373 of 1,756 PTCA patients during the index PTCA. RESULTS: Restenosis occurred in 316 (22.8%) of 1383 non-stent patients versus 62 (16.6%) of 373 (p=0.001) stent patients. For the one-year period following index PTCA, ischemic heart disease (IHD)-related medical costs were not significantly different between stent (mean=$5,898,) and non-stent (Mean=$7,018) groups (P=0.18) nor did total medical costs differ among stent (Mean=$14,128) and non-stent (Mean=$13,621) groups (P=0.71). Logistic regression (including: age, gender, comorbidities, prior year hospitalizations, percent of IHD hospitalizations in prior year, PTCA length of stay, and inpatient-PTCA) revealed lower probability of restenosis (odds ratio=0.7, P=0.02) in stent patients. Cost regressions using the same covariates revealed no significant difference in IHD related costs or total medical costs for the one year period following index PTCA. CONCLUSIONS: Although stented patients had lower restenosis rates, 1-year medical costs following PTCA were not significantly different based on stenting.