Temporal Trends in the Use of Drug-eluting Stents for Approved and Off-label Indications: A Longitudinal Analysis of a Large Multicenter Percutaneous Coronary Intervention Registry
dc.contributor.author | Gualano, Sarah K. | en_US |
dc.contributor.author | Gurm, Hitinder S. | en_US |
dc.contributor.author | Share, David | en_US |
dc.contributor.author | Smith, Dean | en_US |
dc.contributor.author | Aronow, Herbert D. | en_US |
dc.contributor.author | LaLonde, Thomas | en_US |
dc.contributor.author | Bates, Eric R. | en_US |
dc.contributor.author | Changezi, Hameem | en_US |
dc.contributor.author | McNamara, Richard | en_US |
dc.contributor.author | Moscucci, Mauro | en_US |
dc.date.accessioned | 2010-03-01T20:23:10Z | |
dc.date.available | 2011-02-01T20:36:35Z | en_US |
dc.date.issued | 2010-02 | en_US |
dc.identifier.citation | Gualano, Sarah K.; Gurm, Hitinder S.; Share, David; Smith, Dean; Aronow, Herbert D.; LaLonde, Thomas; Bates, Eric R; Changezi, Hameem; McNamara, Richard; Moscucci, Mauro (2010). "Temporal Trends in the Use of Drug-eluting Stents for Approved and Off-label Indications: A Longitudinal Analysis of a Large Multicenter Percutaneous Coronary Intervention Registry." Clinical Cardiology 33(2): 111-116. <http://hdl.handle.net/2027.42/65057> | en_US |
dc.identifier.issn | 0160-9289 | en_US |
dc.identifier.issn | 1932-8737 | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/65057 | |
dc.description.abstract | Background We sought to examine the temporal variations in the rate of both bare-metal stent (BMS) and drug-eluting stent (DES) use for off-label indications after the reports of an increased risk of very late stent thrombosis in patients with DES at the 2006 meeting of the European Society of Cardiology (ESC). Hypothesis To determine whether the decrease in use of DES has affected both on and off-label indications. Methods The study cohort included patients undergoing coronary intervention in a large regional registry, the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2). Patient demographic and clinical characteristics for patients with DES in the third quarter of 2006 (pre-ESC) were compared to those from the fourth quarter of 2008 (post-guideline changes). Use of DES for off-label indications, such as ST-segment elevation myocardial infarction (STEMI), in-stent restenosis (ISR), and saphenous vein graft (SVG) interventions, were evaluated. Results The overall deployment of DES fell sharply from 83% pre-ESC to a plateau of 58% in the first quarter of 2008. This corresponded to a rise in BMS use, while angioplasty procedures stayed the same. The STEMI subgroup showed the most dramatic change, from 78% to only 36%. Off-label use in SVGs showed a similar trend, from 74% to 43%. Drug-eluting stent deployment for ISR was less affected, though it also fell 25% (from 79%–56%). Conclusions The use of DES has fallen dramatically from June 2006 to December 2008, particularly for nonapproved indications. Our study provides a real-world assessment of contemporary change in DES use in response to the presentation of negative observational studies. Copyright © 2010 Wiley Periodicals, Inc. | en_US |
dc.format.extent | 503681 bytes | |
dc.format.extent | 3118 bytes | |
dc.format.mimetype | application/pdf | |
dc.format.mimetype | text/plain | |
dc.publisher | Wiley Periodicals, Inc. | en_US |
dc.subject.other | Medicine and Healthcare | en_US |
dc.subject.other | Cardiovascular Disease | en_US |
dc.title | Temporal Trends in the Use of Drug-eluting Stents for Approved and Off-label Indications: A Longitudinal Analysis of a Large Multicenter Percutaneous Coronary Intervention Registry | en_US |
dc.type | Article | en_US |
dc.rights.robots | IndexNoFollow | en_US |
dc.subject.hlbsecondlevel | Internal Medicine and Specialities | en_US |
dc.subject.hlbtoplevel | Health Sciences | en_US |
dc.description.peerreviewed | Peer Reviewed | en_US |
dc.contributor.affiliationum | Department of Internal Medicine, Division of Cardiovascular Medicine, The University of Michigan, Ann Arbor, Michigan | en_US |
dc.contributor.affiliationum | Department of Internal Medicine, Division of Cardiovascular Medicine, The University of Michigan, Ann Arbor, Michigan | en_US |
dc.contributor.affiliationum | Department of Family Medicine, The University of Michigan, Ann Arbor, Michigan | en_US |
dc.contributor.affiliationum | Department of Internal Medicine, Division of Cardiovascular Medicine, The University of Michigan, Ann Arbor, Michigan | en_US |
dc.contributor.affiliationum | Department of Internal Medicine, Division of Cardiovascular Medicine, The University of Michigan, Ann Arbor, Michigan | en_US |
dc.contributor.affiliationum | Department of Internal Medicine, Division of Cardiovascular Medicine, The University of Michigan, Ann Arbor, Michigan ; Department of Medicine, Cardiovascular Division, University of Miami, Miami, Florida ; Department of Medicine Cardiovascular Division University of Miami, Miller School of Medicine 1430 NW 11th Avenue, MTSL 1001 Miami, Florida 33136 | en_US |
dc.contributor.affiliationother | Clinical Scholars Program, Michigan Heart & Vascular Institute at St. Joseph Mercy Hospital, Ann Arbor, Michigan | en_US |
dc.contributor.affiliationother | St. John Hospital, Detroit, Michigan | en_US |
dc.contributor.affiliationother | Genesys Regional Medical Center, Grand Blanc, Michigan | en_US |
dc.contributor.affiliationother | Spectrum Health, Grand Rapids, Michigan | en_US |
dc.identifier.pmid | 20186993 | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/65057/1/20717_ftp.pdf | |
dc.identifier.doi | 10.1002/clc.20717 | en_US |
dc.identifier.source | Clinical Cardiology | en_US |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
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