Frequency and predictors of drug-eluting stent use in saphenous vein bypass graft percutaneous coronary interventions: A report from the american college of cardiology national cardiovascular data CathPCI registry

Emmanouil S. Brilakis, Tracy Y. Wang, Sunil V. Rao, Subhash Banerjee, Steven Goldman, Kendrick Shunk, Biswajit Kar, David R. Holmes, David Dai, Chee T. Chin, Tina M. Harding, Matthew T. Roe

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1068-1073
Number of pages6
JournalJACC: Cardiovascular Interventions
Volume3
Issue number10
DOIs
StatePublished - Oct 2010
Externally publishedYes

Fingerprint

Drug-Eluting Stents
Saphenous Vein
Percutaneous Coronary Intervention
Cardiology
Registries
Transplants
Stents
Enoxaparin
Platelet Glycoprotein GPIIb-IIIa Complex
Heparin
Coronary Artery Disease
Logistic Models
Smoking
Metals
Myocardial Infarction
Safety

Keywords

  • coronary artery bypass graft surgery
  • drugeluting stent(s)
  • percutaneous coronary intervention
  • saphenous vein graft

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Frequency and predictors of drug-eluting stent use in saphenous vein bypass graft percutaneous coronary interventions : A report from the american college of cardiology national cardiovascular data CathPCI registry. / Brilakis, Emmanouil S.; Wang, Tracy Y.; Rao, Sunil V.; Banerjee, Subhash; Goldman, Steven; Shunk, Kendrick; Kar, Biswajit; Holmes, David R.; Dai, David; Chin, Chee T.; Harding, Tina M.; Roe, Matthew T.

In: JACC: Cardiovascular Interventions, Vol. 3, No. 10, 10.2010, p. 1068-1073.

Research output: Contribution to journalArticle

Brilakis, Emmanouil S. ; Wang, Tracy Y. ; Rao, Sunil V. ; Banerjee, Subhash ; Goldman, Steven ; Shunk, Kendrick ; Kar, Biswajit ; Holmes, David R. ; Dai, David ; Chin, Chee T. ; Harding, Tina M. ; Roe, Matthew T. / Frequency and predictors of drug-eluting stent use in saphenous vein bypass graft percutaneous coronary interventions : A report from the american college of cardiology national cardiovascular data CathPCI registry. In: JACC: Cardiovascular Interventions. 2010 ; Vol. 3, No. 10. pp. 1068-1073.
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title = "Frequency and predictors of drug-eluting stent use in saphenous vein bypass graft percutaneous coronary interventions: A report from the american college of cardiology national cardiovascular data CathPCI registry",
abstract = "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.",
keywords = "coronary artery bypass graft surgery, drugeluting stent(s), percutaneous coronary intervention, saphenous vein graft",
author = "Brilakis, {Emmanouil S.} and Wang, {Tracy Y.} and Rao, {Sunil V.} and Subhash Banerjee and Steven Goldman and Kendrick Shunk and Biswajit Kar and Holmes, {David R.} and David Dai and Chin, {Chee T.} and Harding, {Tina M.} and Roe, {Matthew T.}",
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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.

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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