MedStar Authors catalog › Details for: Impact on in-hospital outcomes with drug-eluting stents versus bare-metal stents (from 665, 804 procedures).
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Impact on in-hospital outcomes with drug-eluting stents versus bare-metal stents (from 665, 804 procedures).

by Chothani, Ankit.
Citation: American Journal of Cardiology. 114(11):1629-37, 2014 Dec 1..Journal: The American journal of cardiology.ISSN: 0002-9149.Full author list: Badheka AO; Arora S; Panaich SS; Patel NJ; Patel N; Chothani A; Mehta K; Deshmukh A; Singh V; Savani GT; Agnihotri K; Grover P; Lahewala S; Patel A; Bambhroliya C; Kondur A; Brown M; Elder M; Kaki A; Mohammad T; Grines C; Schreiber T.UI/PMID: 25439448.Subject(s): Aged | Aged, 80 and over | Cohort Studies | Coronary Artery Disease/mo [Mortality] | *Coronary Artery Disease/th [Therapy] | Databases, Factual | *Drug-Eluting Stents | Female | Hospital Mortality | Humans | Male | Middle Aged | Multivariate Analysis | Myocardial Infarction/mo [Mortality] | *Myocardial Infarction/th [Therapy] | *Percutaneous Coronary Intervention/is [Instrumentation] | Propensity Score | Retrospective Studies | Risk Factors | Stents | Treatment OutcomeInstitution(s): MedStar Washington Hospital CenterDepartment(s): Medicine/General Internal MedicineActivity type: Journal Article.Medline article type(s): Comparative Study | Journal ArticleOnline resources: Click here to access online Digital Object Identifier: http://dx.doi.org/10.1016/j.amjcard.2014.08.033 (Click here) Abbreviated citation: Am J Cardiol. 114(11):1629-37, 2014 Dec 1.Local Holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006.Abstract: Contemporary large-scale data, regarding in-hospital outcomes depending on the types of stent used for percutaneous coronary intervention (PCI) is lacking. We queried the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample from 2006 to 2011 using the International Classification of Diseases, Ninth Revision, Clinical Modification procedure code 36.06 (bare-metal coronary artery stent, BMS) or 36.07 (drug-eluting coronary artery stent, DES) for PCI. All analyses were performed using the designated weighting specified to the Nationwide Inpatient Sample database to minimize bias. Primary outcome was in-hospital mortality. Wald's chi-square test was used for categorical variables. We built a hierarchical 2 level model adjusted for multiple confounding factors, with hospital identification incorporated as random effects in the model and propensity match analyses were used to adjust confounding variables. A total of 665, 804 procedures were analyzed, which were representative of 3, 277, 884 procedures in the United States. Use of bare-metal stents (BMS) was associated with greater occurrence of in-hospital mortality compared with that of drug-eluting stents (DES; 1.4% vs 0.5%, p <0.001). The association stayed significant after adjustment of various possible confounding factors (odds ratio for DES versus BMS 0.59 [0.54 to 0.64, p <0.001]) and also in propensity matched cohorts (1.2% vs 0.7%, p <0.001). The results continued to be similar in the following high-risk subgroups: diabetes (0.57 [0.50 to 0.64, <0.001]), acute myocardial infarction and/or shock (0.53 [0.49 to 0.57, <0.001]), age >80 (0.66 [0.58 to 0.74, <0.001]), and multivessel PCI (0.55 [0.46 to 0.66, <0.001]). In conclusion, DES use was associated with lesser in-hospital mortality compared with BMS. This outcome benefit was seen across subgroups in various subgroups including elderly, diabetics, and acute myocardial infarction as well as multivessel interventions. Copyright � 2014 Elsevier Inc. All rights reserved.

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