Drug-eluting stents: A study of international practice
| Autor: | P. Diane Galbraith, Victor Legrand, Charanjit S. Rihal, Alex McConnachie, David R. Holmes, Jill P. Pell, Keith G. Oldroyd, William A. Ghali, David Austin, Y. Taeymans |
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| Rok vydání: | 2009 |
| Předmět: |
Male
Drug medicine.medical_specialty Minnesota medicine.medical_treatment media_common.quotation_subject Coronary Artery Disease Prosthesis Design Alberta Coronary Restenosis Angioplasty medicine Humans Registries Stent thrombosis Aged Retrospective Studies media_common business.industry Patient Selection International health Drug-Eluting Stents Retrospective cohort study Middle Aged Surgery Clinical Practice Trend analysis Scotland Drug-eluting stent Emergency medicine Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | American Heart Journal. 158:576-584 |
| ISSN: | 0002-8703 |
| Popis: | Objective We aimed to analyze trends in drug-eluting stents (DES) use in four international health care and regulatory settings. Background Accounts suggest a differential approach to DES internationally and recent reductions in use following reports of late stent thrombosis. Current studies of clinical practice are limited in their scope. Methods Data were pooled from angioplasty registries in Alberta (Canada), Belgium, Mayo Clinic (Rochester, MN), and Scotland (UK) that have routinely recorded consecutive patients treated since 2003. Trend analysis was performed to examine variations in DES use over time and by clinical subgroup. Results A total of 178,504 lesions treated between January 2003 and September 2007 were included. In the Mayo Clinic Registry, rapid adoption to a peak of 91% DES use for all lesions by late 2004 was observed. In contrast, Alberta and Scotland showed delayed adoption with lower peak DES use, respectively, 56% and 58% of lesions by early 2006. Adoption of DES in Belgium was more gradual and peak use of 35% lower than other registries. Reductions in DES use were seen in all data sets during 2006, although this varied in absolute and relative terms and by clinical subgroup. Conclusion Adoption and use of DES showed wide variation in four countries. The determinants of use are complex, and it is likely that nonclinical factors predominate. Recent reductions in use may be as a consequence of publicity and concerns regarding late stent thrombosis. The optimum application of DES in clinical practice is unclear and is reflected in the degree of international variation demonstrated. |
| Databáze: | OpenAIRE |
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