Patterns and outcomes of drug-eluting coronary stent use in clinical practice.

Published

Journal Article

OBJECTIVE: To determine patterns and outcomes of drug-eluting stents (DES) use in clinical practice. BACKGROUND: DES are technology associated with superior outcomes. The initial limited availability and high cost of DES had the potential to influence their use. METHODS: Data from the American College of Cardiology-National Cardiovascular Data Registry were examined to describe the patterns of DES use in 408,033 percutaneous coronary intervention (PCI) procedures at 383 sites. Predictors of DES use were determined, and inhospital outcomes were examined. RESULTS: From April 2003 through December 2004, the proportion of procedures using DES increased from 19.7% to 78.2%. DES use increased across all patient groups and hospital types, but adoption was slower among older patients and those without health insurance. DES use varied among hospitals such that use was lower at rural and low-volume hospitals. Multivariable regression demonstrated a progressive decrease in the odds of DES use as age increased. White race, female sex, presence of insurance, diabetes mellitus, PCI of de novo lesion, PCI at a high volume center, and PCI at a suburban hospital were significant predictors of DES use. The availability of a second DES product did not influence the adoption patterns. Inhospital outcomes with DES were excellent. CONCLUSIONS: Access to DES was influenced by demographic, socioeconomic, and hospital characteristics. Further study is needed to determine if the availability of another DES platform or increased overall availability of DES impacts favorably on PCI practice patterns.

Full Text

Duke Authors

Cited Authors

  • Rao, SV; Shaw, RE; Brindis, RG; Klein, LW; Weintraub, WS; Krone, RJ; Peterson, ED

Published Date

  • August 2006

Published In

Volume / Issue

  • 152 / 2

Start / End Page

  • 321 - 326

PubMed ID

  • 16875917

Pubmed Central ID

  • 16875917

Electronic International Standard Serial Number (EISSN)

  • 1097-6744

International Standard Serial Number (ISSN)

  • 0002-8703

Digital Object Identifier (DOI)

  • 10.1016/j.ahj.2006.03.005

Language

  • eng