Abstract 2143: Improved Long-Term Survival in a High Risk Population Following Drug Eluting Stent Availability
Background Data regarding the impact of drug eluting stent (DES) use on long-term outcomes outside trial populations are limited.
Methods 1,547 consecutive patients underwent stent implantation from January 2000 until December 2006 at the San Francisco Veterans Affairs Medical Center. To assess the impact of DES availability on mortality, that population was partitioned into a pre-DES cohort (N=591) and a post-DES availability cohort (N=956). Kaplan-Meier survival curves for the two cohorts were compared.
Results The entire population was relatively high risk: 37% had diabetes, 38% a reduced ejection fraction, and 53% a prior MI or elevated troponin prior to the procedure. Median follow up was 4.7 years for the pre-DES cohort and 1.8 years for the post-DES cohort. DES were used in 83% of procedures in the post-DES cohort. Survival improved significantly in the post-DES cohort (P = .04, Log Rank)(see Figure⇓). Baseline characteristics, procedural variables and discharge medications were analyzed in a Cox proportional hazards model (see Table⇓). DES use was an independent predictor of improved survival (Hazard Ratio for death 0.52, 95% CI .28–.95).
Conclusions In an unselected, high risk population, long-term survival improved following the availability of drug eluting stents. After adjusting for potential confounding factors, DES use was an independent predictor of improved survival.