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
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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