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13-01-2016 | Original Article - ICIN | Uitgave 2/2016 Open Access

Netherlands Heart Journal 2/2016

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

Tijdschrift:
Netherlands Heart Journal > Uitgave 2/2016
Auteurs:
L. T. Burgers, E. A. McClellan, I. E. Hoefer, G. Pasterkamp, J. W. Jukema, S. Horsman, N. H. J. Pijls, J. Waltenberger, M. A. Hillaert, A. C. Stubbs, J. L. Severens, W. K. Redekop

Abstract

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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Netherlands Heart Journal

Het Netherlands Heart Journal wordt uitgegeven in samenwerking met de Nederlandse Vereniging voor Cardiologie en de Nederlandse Hartstichting. Het tijdschrift is Engelstalig en wordt gratis beschikbaa ...

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