Drug-eluting or bare-metal stenting in XXXX with @entity6 : results from the Massachusetts Data Analysis Center Registry.

@entity1 @entity6 @entity4743 @entity256 @entity583
BACKGROUND: @entity1 with @entity6 ( @entity6 ) are at high risk for @entity256 , @entity583 , and cardiac mortality after coronary stenting, and the long-term safety of drug-eluting stents ( @entity4743 ) relative to bare-metal stents (BMS) in @entity6 is uncertain. We report on a large consecutive series of @entity1 with @entity6 followed up for 3 years after @entity4743 and BMS from a regional contemporary US practice with mandatory reporting. METHODS AND RESULTS: All adults with @entity6 undergoing percutaneous coronary intervention with stenting between April 1, 2003, and September 30, 2004, at all acute care nonfederal hospitals in Massachusetts were identified from a mandatory state database. According to index admission stent type, @entity1 were classified as @entity4743 treated if all stents were drug eluting and as BMS treated if all stents were bare metal; @entity1 treated with both types of stents were excluded from the primary analysis. Mortality rates were obtained from vital statistics records, and @entity583 and revascularization rates were obtained from the state database with complete 3 years of follow-up on the entire cohort. Risk-adjusted mortality, @entity583 , and revascularization differences ( @entity4743 -BMS) were estimated with propensity-score matching based on clinical, procedural, hospital, and insurance information collected at the index admission. @entity6 was present in 5051 @entity1 (29% of the population) treated with @entity4743 or BMS during the study. @entity1 with @entity6 were more likely to receive @entity4743 than BMS (66.1% versus 33.9%; P<0.001). The unadjusted cumulative incidence of mortality at 3 years was 14.4% in @entity4743 versus 22.2% in BMS (P<0.001). Based on propensity-score analysis of 1:1 matched @entity4743 versus BMS @entity1 (1476 @entity4743 :1476 BMS), the risk-adjusted mortality, MI, and target vessel revascularization rates at 3 years were 17.5% versus 20.7% (risk difference, -3.2%; 95% confidence interval, -6.0 to -0.4; P=0.02), 13.8% versus 16.9% (-3.0%; 95% confidence interval, -5.6 to 0.5; P=0.02), and 18.4% versus 23.7% (-5.4%; confidence interval, -8.3 to -2.4; P<0.001), respectively. CONCLUSIONS: In a real-world @entity6 @entity1 population with mandatory reporting and follow-up, @entity4743 were associated with reduced mortality, @entity583 , and revascularization rates at long-term follow-up compared with BMS.
