Treatment variation in stent choice in patients with stable or unstable coronary artery disease
| Autor: | Johannes Waltenberger, Elizabeth A. McClellan, Laura Burgers, Joop Jukema, Imo E. Hoefer, A. C. Stubbs, Marieke A. Hillaert, Nico H.J. Pijls, Sebastiaan Horsman, Gerard Pasterkamp, Johan L. Severens, William K. Redekop |
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| Přispěvatelé: | Health Technology Assessment (HTA), Pathology, Cardiovascular Biomechanics, MUMC+: MA Alg Interne Geneeskunde (9), Cardiologie, Beleid Economie & Organisatie vd Zorg |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Bare-metal stent
medicine.medical_specialty medicine.medical_treatment Original Article - ICIN 030204 cardiovascular system & hematology SDG 3 – Goede gezondheid en welzijn Coronary artery disease Percutaneous coronary intervention 03 medical and health sciences 0302 clinical medicine SDG 3 - Good Health and Well-being Internal medicine medicine Journal Article In patient 030212 general & internal medicine cardiovascular diseases business.industry Stent medicine.disease equipment and supplies surgical procedures operative Drug-eluting stent Treatment variation Cardiology business Cardiology and Cardiovascular Medicine |
| Zdroj: | Netherlands Heart Journal, 24, 110-119. Bohn Stafleu van Loghum Netherlands Heart Journal, 24(2), 110-119. Bohn Stafleu van Loghum Netherlands Heart Journal, 24(2), 110. Bohn Stafleu van Loghum Netherlands Heart Journal |
| ISSN: | 1876-6250 1568-5888 |
| Popis: | Aim Variations in treatment are the result of differences in demographic and clinical factors (e.g. anatomy), but physician and hospital factors may also contribute to treatment variation. The choice of treatment is considered important since it could lead to differences in long-term outcomes. This study explores the associations with stent choice: i.e. drug-eluting stent (DES) versus bare-metal stents (BMS) for Dutch patients diagnosed with stable or unstable coronary artery disease (CAD). Methods & results Associations with treatment decisions were based on a prospective cohort of 692 patients with stable or unstable CAD. Of those patients, 442 patients were treated with BMS or DES. Multiple logistic regression analyses were performed to identify variables associated with stent choice. Bivariate analyses showed that NYHA class, number of diseased vessels, previous percutaneous coronary intervention, smoking, diabetes, and the treating hospital were associated with stent type. After correcting for other associations the treating hospital remained significantly associated with stent type in the stable CAD population. Conclusions This study showed that several factors were associated with stent choice. While patients generally appear to receive the most optimal stent given their clinical characteristics, stent choice seems partially determined by the treating hospital, which may lead to differences in longterm outcomes. |
| Databáze: | OpenAIRE |
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