Trends im Einsatz von Drug-eluting Stents im klinischen Alltag in Deutschland

Klein, Bärbel; Zahn, Ralf; Heer, Tobias; Hochadel, Matthias; Tebbe, Ulrich; Darius, Harald; Kerber, Sebastian; Schumacher, Burghard; Grube, Eberhard; Hauptmann, Karl Eugen; Glunz, Hans-Georg; Senges, Jochen; Zeymer, Uwe

doi:10.1007/s00059-008-3097-1

Cited by 3 publications

(1 citation statement)

References 24 publications

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“…1 In the United States (U.S.) alone, an estimated 600,000 PCIs are performed annually at a direct cost of approximately $30 billion, 2-4 with similar trends in Europe and Canada. 5-7 The growth of PCI in the U.S., especially among patients without an acute ST-Elevation myocardial infarction (STEMI), may be encouraged by the generous reimbursement for interventional procedures as compared with medical therapy, which may unintentionally promote overuse of PCI. 7,8 In addition, policy makers and health economists have suggested that complex financial ties between physicians and hospitals may provide additional financial incentives to perform PCI in patients who could be treated effectively with medical therapy alone.…”

Section: Introductionmentioning

confidence: 99%

Indications for percutaneous coronary interventions performed in US hospitals: a report from the NCDR®

Cram

House

Messenger

et al. 2012

American Heart Journal

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Background There are many factors hypothesized as contributing to overuse of percutaneous coronary intervention (PCI) in the United States (U.S.), including financial ties between physicians and hospitals, but empirical data are lacking. We examined PCI indications in not-for-profit (NFP), major teaching, for-profit (FP) and physician-owned specialty hospitals. Methods A retrospective cohort study of 1,113,554 patients who underwent PCI in 694 hospitals (NFP=471, teaching=131, FP=79, specialty=13) participating in the National Cardiovascular Data Registry® (NCDR®) CathPCI Registry® between January 1, 2004 and December 31, 2007. PCI indications derived from American College of Cardiology (ACC) Guidelines were classified as: survival benefit (patients with primary reperfusion for STEMI); potential quality of life (QOL) benefit (patients with NSTEMI, ACS, positive stress test, or chest pain); or unclear indications (patients receiving PCI without an obvious potential survival or QOL benefit). Results The percentage of PCI performed for unclear indications was somewhat higher for specialty hospitals (5.1% of all procedures) as compared with other hospital categories (FP 4.7%, NFP 4.2%, teaching 4.5%; P<0.001). Overall, 17% of hospitals had 20% or more of their total PCI procedures performed for unclear indications but the proportion of FP, NFP, teaching, and specialty hospitals reaching this threshold was not statistically different (20%, 16%, 17% and 15% respectively; P=.84). Conclusions A small proportion of PCI procedures were performed in patients with unclear indications, but there was wide variation across hospitals. On average, specialty hospitals performed more PCIs for unclear indications. Efforts to reduce variability should be pursued.

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Section: Introductionmentioning

confidence: 99%

Indications for percutaneous coronary interventions performed in US hospitals: a report from the NCDR®

Cram

House

Messenger

et al. 2012

American Heart Journal

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Twenty-year outcomes of minimally invasive direct coronary artery bypass surgery: The Leipzig experience

Davierwala

Verevkin

Bergien

et al. 2023

The Journal of Thoracic and Cardiovascular Surgery

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Israel: coronary and structural heart interventions from 2010 to 2015

Finkelstein¹,

Minha²,

Kornowski³

et al. 2017

EuroIntervention

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The Israel Heart Society is a member of the European Society of Cardiology, and the Israeli Working Group of Interventional Cardiology is an active participant in EAPCI. The aim of this manuscript is to provide a snapshot of cardiac interventions performed in the State of Israel during the period 2010-2015. Data for this manuscript were collected via collaboration with the National Diseases Registries Unit of the Israel Center for Disease Control. During the survey period, the Israeli population increased by 7% but only one additional hospital with an active cardiac catheterisation laboratory was opened. The vast majority of the percutaneous procedures are performed in public hospital settings. Total coronary angiography procedures remained stable throughout the survey period, and the percentage of PCI out of total coronary angiography procedures remained approximately 50% throughout the survey period. More than 90% of the PCI procedures were performed using stent deployment, and the use of drug-eluting stents increased significantly during the survey period from 46% in 2010 to 92% in 2015. The number of TAVI procedures increased dramatically, by more than sixfold, from 130 procedures in 2010 to 851 procedures in 2015 (with 130 implants/million population at Q4 of 2015). The vast majority of interventional cardiology procedures are funded by the governmental healthcare providers, and all the citizens of the country have access to the most advanced cardiac interventions. If corrected for the increase in the population, the volumes of coronary interventions are decreasing throughout the country. However, structural heart disease interventions, and specifically valvular interventions, are growing rapidly and this trend is expected to continue in the near future.

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Trends im Einsatz von Drug-eluting Stents im klinischen Alltag in Deutschland

Abstract: : DES were mainly applied in a stable situation (Figure 2), but were also increasingly used for complex coronary interventions in off-label indications.

Cited by 3 publications

References 24 publications

Indications for percutaneous coronary interventions performed in US hospitals: a report from the NCDR®

Indications for percutaneous coronary interventions performed in US hospitals: a report from the NCDR®

Twenty-year outcomes of minimally invasive direct coronary artery bypass surgery: The Leipzig experience

Israel: coronary and structural heart interventions from 2010 to 2015

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