TY - JOUR
T1 - Utilization of Non–Drug-Eluting Devices for Inpatient Percutaneous Coronary Intervention in the United States
AU - Sedhom, Ramy
AU - Cortese, Bernardo
AU - Khedr, Mohamed
AU - Bharadwaj, Aditya
AU - Brilakis, Emmanouil S.
AU - Pershad, Ashish
AU - Basir, Mir B.
AU - Alaswad, Khaldoon
AU - Yeh, Robert W.
AU - Megaly, Michael
N1 - Publisher Copyright:
© 2022 Elsevier Inc.
PY - 2023/1/1
Y1 - 2023/1/1
N2 - There is a paucity of data on the contemporary use of non–drug-eluting devices (balloon angioplasty or bare-metal stents) in contemporary percutaneous coronary intervention (PCI) in the United States. We utilized the Nationwide Readmissions Database to identify patients hospitalized to undergo PCI with non–drug-eluting devices from 2016 to 2019. The main outcome of interest was the trends in utilization over the study years. Among 1,870,262 PCI procedures, 127,810 (6.8%) were performed with non–drug-eluting devices; 72% of these were in the setting of acute myocardial infarction (MI). The use of non–drug-eluting devices decreased throughout the study period from 12.9% of all PCI in the first quarter of 2016 to 3.4% in the last quarter of 2019 (p <0.001). Factors associated with their use included advanced age and high bleeding risk. Only a small percentage were used as a bridge to coronary artery bypass graft surgery (2%) and for treatment of in-stent restenosis (3%). The in-hospital mortality was 5.8% for the entire cohort and 6.6% when the indication for use was an acute MI. In patients presenting with an acute MI, reinfarction within 30 days was common and occurred in 18% of the patients. In conclusion, the use of non–drug-eluting devices in PCI in the United States decreased from 2016 to 2019. Factors associated with their use included old age and high bleeding risk. Due to suboptimal outcomes in patients currently being treated with non–drug-eluting devices, there remains an unmet clinical need for alternative treatment options.
AB - There is a paucity of data on the contemporary use of non–drug-eluting devices (balloon angioplasty or bare-metal stents) in contemporary percutaneous coronary intervention (PCI) in the United States. We utilized the Nationwide Readmissions Database to identify patients hospitalized to undergo PCI with non–drug-eluting devices from 2016 to 2019. The main outcome of interest was the trends in utilization over the study years. Among 1,870,262 PCI procedures, 127,810 (6.8%) were performed with non–drug-eluting devices; 72% of these were in the setting of acute myocardial infarction (MI). The use of non–drug-eluting devices decreased throughout the study period from 12.9% of all PCI in the first quarter of 2016 to 3.4% in the last quarter of 2019 (p <0.001). Factors associated with their use included advanced age and high bleeding risk. Only a small percentage were used as a bridge to coronary artery bypass graft surgery (2%) and for treatment of in-stent restenosis (3%). The in-hospital mortality was 5.8% for the entire cohort and 6.6% when the indication for use was an acute MI. In patients presenting with an acute MI, reinfarction within 30 days was common and occurred in 18% of the patients. In conclusion, the use of non–drug-eluting devices in PCI in the United States decreased from 2016 to 2019. Factors associated with their use included old age and high bleeding risk. Due to suboptimal outcomes in patients currently being treated with non–drug-eluting devices, there remains an unmet clinical need for alternative treatment options.
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U2 - 10.1016/j.amjcard.2022.09.033
DO - 10.1016/j.amjcard.2022.09.033
M3 - Article
C2 - 36328830
AN - SCOPUS:85141258808
SN - 0002-9149
VL - 186
SP - 209
EP - 215
JO - American Journal of Cardiology
JF - American Journal of Cardiology
ER -