Abstract 19334: Responses to a Pre-PCI Screening Questionnaire Influence Stent Type Used During PCI
Introduction: The strong correlation between early termination of dual antiplatelet therapy and stent thrombosis in patients treated with drug-eluting stents (DES) warrants emphasis on appropriate selection of patients for DES. Using a simple questionnaire administered pre-procedurally, we aimed to determine which clinical factors might predict the use of DES during PCI.
Hypothesis: A “yes” response to any item on the pre-PCI questionnaire (table 1) will decrease the odds of DES use during PCI.
Methods: Using the Durham Veterans Affairs electronic health record, we identified 1202 patients who underwent PCI from July 2008 to January 2013. We excluded patients without a complete pre-PCI questionnaire within 14 days of PCI, repeat procedures and those who received both DES and BMS or no stent during PCI, leaving 864 patients. Using logistic regression we performed univariate analyses of age, sex, diabetes, PCI indication (stable angina, unstable angina/NSTEMI or STEMI) and target vessel type (vein graft or native). Only age and PCI indication were significant predictors of DES use (p < 0.10). Adjusting for age and PCI indication with multivariate logistic regression, we then determined the association between “yes” responses to questionnaire items and DES use.
Results: Of the 864 patients receiving stents, 661 received DES and 203 received BMS. Increasing age, presenting with STEMI, and a “yes” response to any item on the questionnaire decreased the odds of DES use, however, this was not significant for questions 2 and 6 (table 1). Presenting with unstable angina or NSTEMI, as compared with stable angina, significantly increased the odds of DES use.
Conclusions: Age, PCI indication and responses to 4 of 6 items on a questionnaire administered pre-PCI were associated with stent type used during PCI. Future studies should investigate whether implementation of this questionnaire leads to lower rates of stent thrombosis through appropriate patient selection for DES.
- Percutaneous coronary intervention (PCI)
- Drug eluting stents
- Acute coronary syndromes
- Interventional cardiology
- Quality improvement
Author Disclosures: M.J. Chung: None. S.V. Rao: None. T.J. Povsic: None. W.S. Jones: None. R.D. Schulteis: None.
- © 2014 by American Heart Association, Inc.