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A199 JACC April 1, 2014 Volume 63, Issue 12 Acute Coronary Syndromes DRUG-ELUTING STENTS ARE ASSOCIATED WITH BETTER OUTCOMES COMPARED TO BARE-METAL STENTS IN UNSTABLE ANGINA OR NON ST-ELEVATION MYOCARDIAL INFARCTION PATIENTS UNDERGOING PERCUTANEOUS CORONARY INTERVENTION Poster Contributions Hall C Sunday, March 30, 2014, 3:45 p.m.-4:30 p.m. Session Title: Clinical Perspectives on Management of Non-ST-Segment Elevation Acute Coronary Syndrome Abstract Category: 3. Acute Coronary Syndromes: Therapy Presentation Number: 1225-238 Authors: Georges Ephrem, Venkatesan Vidi, Zia Rab, Michael Kim, Rajiv Jauhar, Perwaiz Meraj, Hofstra North Shore-LIJ School of Medicine at North Shore-LIJ Health System, New Hyde Park, NY, USA Background: The 2011 ACCF/AHA/SCAI Guidelines for Percutaneous Coronary Intervention (PCI) considered drug-eluting stents (DES) as a useful alternative to bare-metal ones (BMS). The hypotheses of this study are that the use of DES is non-random in unstable angina (UA) or non ST- elevation myocardial infarction (NSTEMI) patients undergoing PCI and that DES use is associated with better outcomes. Methods: Prospectively-collected data of UA/NSTEMI patients undergoing PCI from 01/01/2011 till 03/31/2013 at 2 tertiary care centers in New York was analyzed. The results were confirmed with propensity-score-adjusted analysis. The primary endpoint was death (index admission or 30-day), the secondary adverse outcome (composite of death, dissection, perforation, myocardial infarction, cerebrovascular accident, bleeding, transfusion, and coronary artery bypass graft). Results: Of the 4,687 study subjects, those with DES (n = 4,269 (91%)) were on average younger, Asian, non-Hispanics, with private insurance, lesser prevalence of comorbidities, smaller vessel diameter, and had longer stents than patients with BMS. In propensity-score adjusted logistic regression analysis, DES use was associated with lower mortality and adverse outcomes (Table). Conclusion: In UA/NSTEMI patients undergoing PCI, DES were more often deployed in younger, Asian, non-Hispanic patients, with private insurance and lesser comorbidities. DES use was associated with lower mortality and adverse outcomes.
