TY - JOUR
T1 - Frequency and predictors of drug-eluting stent use in saphenous vein bypass graft percutaneous coronary interventions
T2 - A report from the american college of cardiology national cardiovascular data CathPCI registry
AU - Brilakis, Emmanouil S.
AU - Wang, Tracy Y.
AU - Rao, Sunil V.
AU - Banerjee, Subhash
AU - Goldman, Steven
AU - Shunk, Kendrick
AU - Kar, Biswajit
AU - Holmes, David R.
AU - Dai, David
AU - Chin, Chee T.
AU - Harding, Tina M.
AU - Roe, Matthew T.
N1 - Funding Information:
Dr. Brilakis has received speaker honoraria from St. Jude Medical, consulting fees from Medicure, and research support from Abbott Vascular ; furthermore, his spouse is an employee of Medtronic. Dr. Wang has received research support from Bristol-Myers Squibb/Sanofi Partnership , Schering-Plough , The Medicines Company , Heartscape Technologies , Canyon Pharmaceuticals , and Eli Lilly/Daiichi Sankyo Alliance . Dr. Rao has received research funding from Cordis Corporation , Momenta Pharmaceuticals , and Portola Pharmaceuticals ; and speaker honoraria from The Medicines Company, Sanofi-Aventis, Bristol-Myers Squibb, and AstraZeneca. Dr. Banerjee has received speaker honoraria from St. Jude Medical, Medtronic, and Johnson & Johnson; and research support from Boston Scientific and The Medicines Company . Dr. Roe has received research funding from Eli Lilly, Bristol-Myers Squibb, Sanofi-Aventis, and Merck-Schering Plough; and consulting and honoraria from GlaxoSmithKline, Novartis, Eli Lilly, Bristol-Myers Squibb, Sanofi-Aventis, Merck-Schering Plough, and AstraZeneca. All other authors report that they have no relationships to disclose. Morton J. Kern, MD, served as Guest Editor for this paper.
PY - 2010/10
Y1 - 2010/10
N2 - Objectives We examined a large registry to determine the frequency and factors associated with drug-eluting stents (DES) use in saphenous vein graft (SVG) in contemporary practice. Background Prospective trials comparing DES with bare-metal stents in SVG lesions have provided conflicting conclusions regarding safety and efficacy leading to potential variation in stent choice for these lesions. Methods We analyzed the frequency and factors associated with DES use in patients undergoing SVG stenting from January 1, 2004, to March 31, 2009, in the National Cardiovascular Data Registry. Generalized estimating equations logistic regression modeling was used to generate independent variables associated with DES use in SVGs. Results During the study period, percutaneous coronary intervention (PCI) of a SVG represented 5.7% of the total PCI volume (91,355 of 1,596,966). Of the 84,875 patients who received a SVG stent, a DES was used in 64.5%. From 2005 to 2009, DES use in SVG PCI changed from 80% to 62%. Unfractionated heparin was used in 46%, enoxaparin in 17%, bivalirudin in 42%, and a glycoprotein IIb/IIIa inhibitor in 40% of cases. On multivariable analysis, several parameters (including the period, multivessel PCI, prior PCI, no acute myocardial infarction, and no smoking) were associated with DES use. Conclusions Currently, DES are used in nearly two-thirds of SVG interventions. Several clinical parameters (such as the period of implantation and the complexity of coronary artery disease) are associated with the decision to implant a DES in these challenging lesions.
AB - Objectives We examined a large registry to determine the frequency and factors associated with drug-eluting stents (DES) use in saphenous vein graft (SVG) in contemporary practice. Background Prospective trials comparing DES with bare-metal stents in SVG lesions have provided conflicting conclusions regarding safety and efficacy leading to potential variation in stent choice for these lesions. Methods We analyzed the frequency and factors associated with DES use in patients undergoing SVG stenting from January 1, 2004, to March 31, 2009, in the National Cardiovascular Data Registry. Generalized estimating equations logistic regression modeling was used to generate independent variables associated with DES use in SVGs. Results During the study period, percutaneous coronary intervention (PCI) of a SVG represented 5.7% of the total PCI volume (91,355 of 1,596,966). Of the 84,875 patients who received a SVG stent, a DES was used in 64.5%. From 2005 to 2009, DES use in SVG PCI changed from 80% to 62%. Unfractionated heparin was used in 46%, enoxaparin in 17%, bivalirudin in 42%, and a glycoprotein IIb/IIIa inhibitor in 40% of cases. On multivariable analysis, several parameters (including the period, multivessel PCI, prior PCI, no acute myocardial infarction, and no smoking) were associated with DES use. Conclusions Currently, DES are used in nearly two-thirds of SVG interventions. Several clinical parameters (such as the period of implantation and the complexity of coronary artery disease) are associated with the decision to implant a DES in these challenging lesions.
KW - coronary artery bypass graft surgery
KW - drugeluting stent(s)
KW - percutaneous coronary intervention
KW - saphenous vein graft
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U2 - 10.1016/j.jcin.2010.07.009
DO - 10.1016/j.jcin.2010.07.009
M3 - Article
C2 - 20965466
AN - SCOPUS:77958617618
SN - 1936-8798
VL - 3
SP - 1068
EP - 1073
JO - JACC: Cardiovascular Interventions
JF - JACC: Cardiovascular Interventions
IS - 10
ER -