Journal article
Impact on In-Hospital Outcomes With Drug-Eluting Stents Versus Bare-Metal Stents (from 665,804 Procedures)
The American journal of cardiology, Vol.114(11), pp.1629-1637
12/01/2014
DOI: 10.1016/j.amjcard.2014.08.033
PMID: 25439448
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.
Details
- Title: Subtitle
- Impact on In-Hospital Outcomes With Drug-Eluting Stents Versus Bare-Metal Stents (from 665,804 Procedures)
- Creators
- Apurva O Badheka - Department of Cardiology, Detroit Medical Center, Detroit, MichiganShilpkumar Arora - Department of Cardiology, Detroit Medical Center, Detroit, MichiganSidakpal S Panaich - Department of Cardiology, Detroit Medical Center, Detroit, MichiganNileshkumar J Patel - Department of Cardiology, Staten Island University Hospital, Staten Island, New YorkNilay Patel - Department of Cardiology, Detroit Medical Center, Detroit, MichiganAnkit Chothani - Department of Cardiology, MedStar Washington Hospital Center, Washington, DCKathan Mehta - Department of Cardiology, University of Pittsburgh Medical Center Shadyside Hospital, Pittsburgh, PennsylvaniaAbhishek Deshmukh - Department of Cardiology, University of Arkansas, Little Rock, ArkansasVikas Singh - Department of Cardiology, University of Miami Miller School of Medicine, Miami, FloridaGhanshyambhai T Savani - Department of Cardiology, University of Miami Miller School of Medicine, Miami, FloridaKanishk Agnihotri - Department of Cardiology, Detroit Medical Center, Detroit, MichiganPeeyush Grover - Department of Cardiology, University of Miami Miller School of Medicine, Miami, FloridaSopan Lahewala - Department of Cardiology, Mount Sinai Hospital, New York, New YorkAchint Patel - Department of Cardiology, Mount Sinai Hospital, New York, New YorkChirag bambhroliya - Department of Cardiology, Detroit Medical Center, Detroit, MichiganAshok Kondur - Department of Cardiology, Detroit Medical Center, Detroit, MichiganMichael Brown - Department of Cardiology, Detroit Medical Center, Detroit, MichiganMahir Elder - Department of Cardiology, Detroit Medical Center, Detroit, MichiganAmir Kaki - Department of Cardiology, Detroit Medical Center, Detroit, MichiganTamam Mohammad - Department of Cardiology, Detroit Medical Center, Detroit, MichiganCindy Grines - Department of Cardiology, Detroit Medical Center, Detroit, MichiganTheodore Schreiber - Department of Cardiology, Detroit Medical Center, Detroit, Michigan
- Resource Type
- Journal article
- Publication Details
- The American journal of cardiology, Vol.114(11), pp.1629-1637
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.amjcard.2014.08.033
- PMID
- 25439448
- ISSN
- 0002-9149
- eISSN
- 1879-1913
- Language
- English
- Date published
- 12/01/2014
- Academic Unit
- Cardiovascular Medicine; Internal Medicine
- Record Identifier
- 9984094517502771
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