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Treatment variation in stent choice in patients with stable or unstable coronary artery disease

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...

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Autores principales: Burgers, L. T., McClellan, E. A., Hoefer, I. E., Pasterkamp, G., Jukema, J. W., Horsman, S., Pijls, N. H. J., Waltenberger, J., Hillaert, M. A., Stubbs, A. C., Severens, J. L., Redekop, W. K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Bohn Stafleu van Loghum 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4722012/
https://www.ncbi.nlm.nih.gov/pubmed/26762359
http://dx.doi.org/10.1007/s12471-015-0783-5
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author Burgers, L. T.
McClellan, E. A.
Hoefer, I. E.
Pasterkamp, G.
Jukema, J. W.
Horsman, S.
Pijls, N. H. J.
Waltenberger, J.
Hillaert, M. A.
Stubbs, A. C.
Severens, J. L.
Redekop, W. K.
author_facet Burgers, L. T.
McClellan, E. A.
Hoefer, I. E.
Pasterkamp, G.
Jukema, J. W.
Horsman, S.
Pijls, N. H. J.
Waltenberger, J.
Hillaert, M. A.
Stubbs, A. C.
Severens, J. L.
Redekop, W. K.
author_sort Burgers, L. T.
collection PubMed
description 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 long-term outcomes.
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spelling pubmed-47220122016-01-28 Treatment variation in stent choice in patients with stable or unstable coronary artery disease Burgers, L. T. McClellan, E. A. Hoefer, I. E. Pasterkamp, G. Jukema, J. W. Horsman, S. Pijls, N. H. J. Waltenberger, J. Hillaert, M. A. Stubbs, A. C. Severens, J. L. Redekop, W. K. Neth Heart J Original Article - ICIN 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 long-term outcomes. Bohn Stafleu van Loghum 2016-01-13 2016-02 /pmc/articles/PMC4722012/ /pubmed/26762359 http://dx.doi.org/10.1007/s12471-015-0783-5 Text en © The Author(s) 2015 https://creativecommons.org/licenses/by/4.0/ Open Access This article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
spellingShingle Original Article - ICIN
Burgers, L. T.
McClellan, E. A.
Hoefer, I. E.
Pasterkamp, G.
Jukema, J. W.
Horsman, S.
Pijls, N. H. J.
Waltenberger, J.
Hillaert, M. A.
Stubbs, A. C.
Severens, J. L.
Redekop, W. K.
Treatment variation in stent choice in patients with stable or unstable coronary artery disease
title Treatment variation in stent choice in patients with stable or unstable coronary artery disease
title_full Treatment variation in stent choice in patients with stable or unstable coronary artery disease
title_fullStr Treatment variation in stent choice in patients with stable or unstable coronary artery disease
title_full_unstemmed Treatment variation in stent choice in patients with stable or unstable coronary artery disease
title_short Treatment variation in stent choice in patients with stable or unstable coronary artery disease
title_sort treatment variation in stent choice in patients with stable or unstable coronary artery disease
topic Original Article - ICIN
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4722012/
https://www.ncbi.nlm.nih.gov/pubmed/26762359
http://dx.doi.org/10.1007/s12471-015-0783-5
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