The following is the summary of “Utilization of Non–Drug-Eluting Devices for Inpatient Percutaneous Coronary Intervention in the United States” published in the January 2023 issue of Cardiovascular Disease by Sedhom, et al.
Few studies have examined the effectiveness of non-drug-eluting devices (such as balloon angioplasty or bare-metal stents) in modern percutaneous coronary intervention (PCI) in the United States. Researchers identified patients hospitalized for PCI using non-drug-eluting devices between 2016 and 2019 using the National Readmissions Database. Changes in utilization across the years of the study were the primary focus.
Non-drug eluting devices were used in 127,810 (6.1%) of 1,870,262 PCI procedures; 72% of these were for acute myocardial infarction (MI). In the first quarter of 2016, non-drug-eluting devices accounted for 12.9% of all PCI; by the fourth quarter of 2019, that number had dropped to 3.4% (P<0.001). Age and a high risk of bleeding were factors in their increased use. Only 2% of stents were used as a stopgap before CABG, and 3% were utilized to treat restenosis within the stent. Overall, 5.8% of the sample died while hospitalized, and 6.6% of those with an acute myocardial infarction died.
About 18% of patients who presented with an acute MI had a reinfarction within 30 days. To sum up, from 2016 to 2019, PCI centers in the United States used fewer devices that did not release drugs throughout the procedure. Age and a significant risk of bleeding were factors in their use. Since current patients treated with non-drug-eluting devices have less-than-ideal outcomes, there is a significant unmet clinical need for improved therapies.
Source: sciencedirect.com/science/article/abs/pii/S0002914922010621