Abstract 11: Impact of DES Versus BMS on Quality of Life Following Percutaneous Coronary Intervention: Insights From the TRIUMPH Registry

Abstract

Background: While drug eluting stents (DES) are known to reduce restenosis, as compared with bare metal stents (BMS), the comparative effectiveness of stent type on health status outcomes after acute myocardial infarction (AMI) is unknown. Methods: We compared 6-month health status outcomes in 1,583 AMI patients enrolled in the 26-center TRIUMPH study who were treated exclusively with DES (n=974) or BMS (n=609). Patient-reported health status was assessed with the Seattle Angina Questionnaire (SAQ) and the physical and mental summary scales of the Short-Form 12 (SF-12). A multivariate linear regression model was used to examine the association between stent type and patient-reported health status after extensive adjustment for 25 demographic, clinical and procedural variables, including baseline health status. Findings: Patients were predominantly Caucasian (77.8%) and male (73.2%), with a mean age of 59±11 years and a high prevalence of cardiovascular risk factors, including hypertension (58.9%), dyslipidemia (48.5%), and diabetes (23.7%). Baseline health status was similar in the DES and BMS groups, and both groups experienced significant improvements in their health status within 6 months. At 6 months, treatment with DES was associated with significantly greater improvements in the SAQ quality of life (+3.61, 95% C.I. 1.55-5.67), SAQ physical limitation (+5.63, 95% C.I. 3.25-8.00), and SF-12 mental component (+1.38, 95% C.I. 0.37-2.39) scores at 6 months. Changes in the SAQ treatment satisfaction, SAQ angina frequency, and the SF-12 physical component scores were not statistically different between groups. Conclusions: Among unselected patients undergoing PCI for AMI, DES use was associated with a greater improvement in patient-reported health status measures during 6 month follow up as compared with BMS. Further investigation is needed to determine the mechanisms of this benefit and whether it is sustained during longer term follow up.