Abstract
Background: Drug-eluting stent (DES) use in Australian private hospitals enjoyed initial enthusiasm due to their effectiveness in reducing restenosis, followed by a reduction in use following reports of late DES thrombosis (LST) in 2006. We aimed to assess the current utilisation of DES in private hospitals across the nation to assess whether further data clarifying a low rate of DES thrombosis as well as intense scrutiny of the literature regarding the benefits of DES have altered DES usage. Methods: We compared quarterly DES use as a percentage of the total number of stents deployed between June to September 2006 (n=1179), October 2007 to January 2008 (n=1179) and November 2009 to February 2010 (n=951) across six Australian private hospitals. Fisher's exact test (2 tailed) and Chi-square were used to assess the data for significant change. Results: Interval P value June-Sep 06 Oct 07-Jan 08 Nov 08-Feb 10 % DES use 81.1 * 69.8 64.8 * <0.0001 * 69.8 64.8 0.20 * p for 2006 vs. 2008-10 Conclusion: The initial enthusiasm for DES was tempered by concerns regarding possible late stent thrombosis. DES use has not increased again despite further data demonstrating low rates of LST, and the emergence of newer DES platforms. DES usage may have plateaued due to clearer recognition of the most appropriate balance between risk and benefit.
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