Abstract 20233: Does Evidence Influence Practice in the Real World? Secular Trends in Indication for PCI and Use of Drug-Eluting vs. Bare-Metal Stents From 2006-2012

Introduction: In this study, we examined the real-world impact of research evidence on the use of and indications for percutaneous coronary intervention (PCI) (before and after COURAGE Trial publication) and the choice of drug eluting stents (DES) vs. bare metal stents (BMS) (before and after FDA warnings about risk of DES thrombosis). Methods: We used hospital discharge data from Florida to calculate the distribution of primary indication for PCI and the % of PCI patients who received DES, BMS, or no stent on a quarterly basis from Jan 2006 - Jun 2012. We plotted stent trends separately for patients with principal diagnosis of STEMI (n=66,054), NSTEMI/ICS (n=140,886), and stable CHD (n=117,307). Results: Since 2006, the % of PCIs with a primary indication of either STEMI or NSTEMI has steadily increased, while the % with an indication of stable CHD declined from 45% to 28%. In early 2006, DES were used in 86.9% of NSTEMI patients, 87.5% of stable CHD patients, and 81.4% of STEMI patients. DES use first d...