| Drug-eluting stents versus bare-metal stents for off-label indications: a propensity score-matched outcome study. | |
| | |
MedLine Citation:
|
PMID: 20031654 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: The US Food and Drug Administration recently concluded that data on off-label drug-eluting stent (DES) safety are limited. However, in actual clinical practice, DES are often used for off-label indications, and observational studies demonstrate that complications are higher when compared with on-label use. We aimed to determine whether clinical outcomes differ after DES and bare-metal stent implantation in a patient cohort defined by DES off-label indications. METHODS AND RESULTS: We used the national revascularization registry in Scotland to identify patients who underwent coronary stenting for an off-label indication between January 2003 and September 2005. Individual-level linkage to comprehensive national admission and death databases was used to ascertain the end points of death, myocardial infarction, and target-vessel revascularization. We calculated propensity scores on the basis of clinical, demographic, and angiographic variables and matched DES to bare-metal stents on a 1:1 basis. The final study population consisted of 1642 patients, well matched for important covariables at baseline. Event-free survival was calculated over 24 months with the Kaplan-Meier method. All-cause death was more common after bare-metal stent implantation during follow-up (7.7% versus 6.6%; hazard ratio 0.63; 95% confidence interval, 0.40 to 0.99; P=0.04). No difference in the rates of myocardial infarction were noted (7.3% versus 7.5%; hazard ratio 1.02; 95% confidence interval, 0.69 to 1.54; P=0.92). Target-vessel revascularization was reduced in patients treated with DES (13.9% versus 10.7%; hazard ratio 0.67; 95% confidence interval, 0.49 to 0.93; P=0.02). CONCLUSIONS: At 24 months, patients treated with DES for off-label indications had lower rates of death and target-vessel revascularization and similar rates of myocardial infarction, as compared with patients treated with bare-metal stents. |
| | |
Authors:
|
David Austin; Keith G Oldroyd; Alex McConnachie; Rachel Slack; Hany Eteiba; Andrew D Flapan; Kevin P Jennings; Robin J Northcote; Alastair C H Pell; Ian R Starkey; Jill P Pell |
Related Documents
:
|
12426824 - A porcine coronary stent model of increased neointima formation in the left anterior de... 9708454 - Sustained benefit of stenting chronic coronary occlusion: long-term clinical follow-up ... 16519084 - A study on anterior clinoid process and optic strut with emphasis on variations of caro... 16926324 - Acute myocardial infarction: safety of cardiac mr imaging after percutaneous revascular... 9183334 - Ischemic cerebral infarction after rt-pa and heparin therapy for acute myocardial infar... 1495284 - Superior qualities of university of wisconsin solution for ex vivo preservation of the ... |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Circulation. Cardiovascular interventions Volume: 1 ISSN: 1941-7632 ISO Abbreviation: Circ Cardiovasc Interv Publication Date: 2008 Aug |
Date Detail:
|
Created Date: 2009-12-24 Completed Date: 2010-06-09 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 101499602 Medline TA: Circ Cardiovasc Interv Country: United States |
Other Details:
|
Languages: eng Pagination: 45-52 Citation Subset: IM |
Affiliation:
|
University of Glasgow, UK. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Blood Vessel Prosthesis Implantation / adverse effects*, mortality Cohort Studies Coronary Occlusion / therapy* Drug-Eluting Stents / adverse effects*, statistics & numerical data Female Humans Male Metals Middle Aged Myocardial Infarction / etiology*, mortality Off-Label Use / statistics & numerical data Propensity Score Registries* Scotland Survival Analysis Treatment Outcome |
| Chemical | |
Reg. No./Substance:
|
0/Metals |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Validation of the mayo clinic risk score for in-hospital mortality after percutaneous coronary inter...
Next Document: Aortic wall injury as a complication of neonatal aortic valvuloplasty: incidence and risk factors.