Abstract 11774: Beyond Restenosis - Patients’ Preferences for Drug Eluting versus Bare Metal Stents

Abstract

Introduction: Drug eluting stents (DES) reduce the need for target vessel revascularization, and are used in ~80% of percutaneous coronary interventions (PCI) in the US. However, DES also necessitate the use of prolonged dual anti-platelet therapy (DAPT), which is associated with increased bleeding/bruises, can complicate future surgeries and can increase patients’ medication costs (DAPT drawbacks). Patients’ preferences regarding the benefits of DES and DAPT drawbacks have not previously been studied or reported. Methods: In a prospective, observational cohort study, consecutive patients undergoing PCI at 2 Kansas City hospitals completed a survey assessing the importance of the following factors related to the decision to receive DES: need for repeat PCI and DAPT drawbacks. Each factor was rated from 1 (not important) to 10 (extremely important). The most important factor, or group of factors, to each patient was then identified. Results: Among 317 PCI patients (66% male, 71% white, 45% DM, 80% HTN, 43% with prior PCI), 21% did not consider the need for repeat PCI as the most important factor (Figure). Only 14% considered the need for repeat PCI the single most important factor and 65% considered at least one DAPT drawback as important as repeat PCI. A third (32.8%) ranked minor bleeding/bruising as the most important factor (alone (5.5%) or with other domains (27.3%)). Conclusions: While the need for repeat PCI is an important factor to patients considering stent options, 85% of PCI patients regard other factors to be at least as important. Eliciting patients’ preferences is important to better tailor stent choices to the goals and values of individual patients undergoing PCI.