Differences In Short Term In-Hospital Outcomes in Patients Undergoing Bare-Metal stenting vs Drug-Eluting Stenting

Background:
Bare-metal stents (BMS) and Drug-eluting stents (DES) are two common methods of intervention in patients with coronary artery disease. Several studies have previously explored the different predictors of poor outcomes in the usage of BMS vs. DES. This study aims to further the understanding of these intervention’s in-hospital outcomes.

Methods:
This retrospective cohort study used ICD9 codes and data from the Nationwide Inpatient Sample (2012-15) to identify adults diagnosed with a STEMI who underwent stenting with either a BMS or DES. Patients missing important clinical identifiers (age, gender, death, race) and if they had both procedures performed were excluded. Hospital length of stay (LOS), total inpatient charges, mortality, and average age at admission were assessed. Pearson’s chi-squared test and independent t-test were used to analyze the data.

Results:
15,896 encounters were identified with a diagnosis of a STEMI and of these 3,830 were BMS and 12,0666 were DES (average age of 62.33 and 61.26, respectively).Higher mortality was noted in patients who had undergone BMS vs DES (10.5% vs 4.5%, p=0.000). The BMS patients had higher total charges accumulated ($97,764 vs $89,803, 95% CI 3,895 to 12,026: p=0.000). Increased LOS was observed in patients who had underwent BMS vs DES (5.16 vs 4.25, 95% CI .637 to 1.172, p=0.000).

Conclusions:
This study found that patients who underwent bare-metal stenting who were diagnosed with a STEMI had a higher mortality rate, longer length of stay, and more total inpatient charges accumulated than those who had a DES. The results of this study can lead to better awareness of factors that may be contributing to the large discrepancy in these short-term in-hospital outcomes. Which can potentially help reduce the clinical and socioeconomic burden on these patients.