Survival outcomes post percutaneous coronary intervention: Why the hype about stent type? Lessons from a healthcare system in India
Autor: | Archana Avhad, Pushpendra Singh, Bhanu Duggal, Meeta Rajivlochan, Jyothi Subramanian, Anurag Agrawal, Mona Duggal, Sujata Saunik, Sayan Sen, Koundinya Desiraju, Usha Ram |
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Jazyk: | angličtina |
Rok vydání: | 2018 |
Předmět: |
Male
Cardiovascular Procedures medicine.medical_treatment Myocardial Infarction lcsh:Medicine Coronary Artery Disease 030204 cardiovascular system & hematology Vascular Medicine Angina Coronary artery disease Machine Learning 0302 clinical medicine Risk Factors Medicine and Health Sciences Coronary Heart Disease 030212 general & internal medicine Prospective Studies lcsh:Science Multidisciplinary Mortality rate Hazard ratio Drug-Eluting Stents Middle Aged Treatment Outcome Engineering and Technology Female Stents Management Engineering Research Article medicine.medical_specialty Computer and Information Sciences Coronary Stenting Death Rates Cardiology India Surgical and Invasive Medical Procedures 03 medical and health sciences Insurance Percutaneous Coronary Intervention Population Metrics Artificial Intelligence medicine Humans Proportional Hazards Models Percutaneous Transluminal Coronary Angioplasty Risk Management Population Biology business.industry Unstable angina Angioplasty lcsh:R Percutaneous coronary intervention Stent Biology and Life Sciences medicine.disease Emergency medicine Conventional PCI Stent Implantation lcsh:Q business Coronary Angioplasty Delivery of Health Care |
Zdroj: | PLoS ONE, Vol 13, Iss 5, p e0196830 (2018) PLoS ONE |
ISSN: | 1932-6203 |
Popis: | A prospective, multicenter study was initiated by the Government of Maharashtra, India, to determine predictors of long-term outcomes of percutaneous coronary intervention (PCI) for coronary artery disease, and to compare the effectiveness of drug-eluting stents (DESs) and bare-metal stents (BMSs) in patients undergoing PCI under government-funded insurance. The present analysis included 4595 patients managed between August 2012 and November 2016 at any of 110 participating centers. Using the classical multivariable regression and propensity-matching approach, we found age to be the most important predictor of 1-year mortality and target lesion revascularization at 1 year post-PCI. However, using machine learning methods to account for unmeasured confounders and bias in this large observational study, we determined total stent length and number of stents deployed as the most important predictors of 1-year survival, followed by age and employment status. The unadjusted death rates were 5.0% and 3.8% for the BMS and DES groups, respectively (p = 0.185, log-rank test). The rate of re-hospitalization (p |
Databáze: | OpenAIRE |
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