About Half of Repeat PCIs Attributed to Original Stent Placement, NCDR Study Shows
About half of repeat PCIs following implantation of a drug-eluting stent could be attributed to the same coronary artery as the original stent placement, according to a study published Feb. 16 in the Journal of the American Heart Association.
Sanket S. Dhruva, MD, MHS, FACC, et al., used ACC's CathPCI Registry and Medicare claims data to determine the extent to which adverse events identified with claims data could be attributed to a previously placed stent. The researchers identified patients age 65 and older who underwent a repeat PCI within one year following PCI with implantation of a drug-eluting stent. Repeat PCIs were linked back to the CathPCI Registry to determine how often revascularization could reasonably be attributed to the same coronary artery.
Results showed that of 415,305 drug-eluting stent placements in 368,194 patients, the researchers identified 33,174 repeat PCIs within one year. Among repeat PCIs, 16,942 (51.1%) were target vessel revascularization (TVR) – defined as a repeat PCI in the same vessel treated in the initial procedure. Among TVRs, 8,544 (50.4%) were in a previously placed drug-eluting stent.
AMI occurred in 16,176 patients within one year. Of these patients, 4,446 (27.5%) were attributed to the same coronary artery as the drug-eluting stent implantation. In addition, 24,288 patients died within one year. Among those patients, 278 (1.1%) were attributed to the same coronary artery in which the drug-eluting stent was implanted.
According to the researchers, half of PCIs in the year following drug-eluting stent placement "could be reasonably attributable to the same coronary artery." Real-world sources, such as claims data, even when linked to a national registry "may be insufficient" for postmarket surveillance of drug-eluting stents, they write. Moving forward, new strategies that combine complementary data sources will be needed to "inform a robust postmarket surveillance system," they conclude.
Clinical Topics: Invasive Cardiovascular Angiography and Intervention
Keywords: Drug-Eluting Stents, Coronary Vessels, Percutaneous Coronary Intervention, Registries, Stents, National Cardiovascular Data Registries, CathPCI Registry
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