[Temporal trends in the use of drug-eluting stents in German clinical practice].
OBJECTIVE
: Drug-eluting stents (DES) have been shown to reduce the risk of in-stent stenosis, one of the major problems of percutaneous coronary intervention (PCI) with implantation of baremetal stents. DES are approved in Germany since 2002. The following study is based on data of the ALKK PCI registry and assesses the use of DES depending on patient characteristics, indication and coronary status comparing the treatment years 2003 and 2005.


METHODS
: The ALKK (Arbeitsgemeinschaft Leitende Kardiologische Krankenhausärzte) PCI registry is focused on quality management based on guidelines in coronary interventions. Data were obtained by standardized questionnaires and analyzed centrally at the KL-Neuhaus Datenzentrum, Ludwigshafen, Germany. For this study, data of 40,434 PCI procedures of 32 hospitals were obtained.


RESULTS
: In 2003, a total of 18,564 PCIs, and in 2005, a total of 21,870 PCIs were registered. Figure 1 shows the rate of DES in PCI in the hospitals participating in the registry in both years, 2003 and 2005. The use of DES was low with 4.3% in 2003 and increased to 19.1% in 2005. DES were mostly used in patients with stable angina (2003: 68.4%, 2005: 55.3%), in patients with former PCI (2003: 42.5%, 2005: 48.1%) and a positive stress test (DES 2003: 58.4%, 2005: 32.0%; Table 1). The rate of DES was high in unprotected left main procedures (DES 2003: 15.6%, 2005: 35.9%), PCI of ostial lesions (DES 2003: 6.4%, 2005: 32.7%), in in-stent stenosis (DES 2003: 9.5%, 2005: 40.6%), and in multivessel PCI (DES 2003: 7.6%, 2005: 29.3%; Figure 3).


CONCLUSIONS
: DES were mainly applied in a stable situation (Figure 2), but were also increasingly used for complex coronary interventions in off-label indications.
Klein
Bärbel
B
Medizinische Klinik B, Klinikum der Stadt Ludwigshafen, Herzzentrum, Ludwigshafen.
Zahn
Ralf
R
Heer
Tobias
T
Hochadel
Matthias
M
Tebbe
Ulrich
U
Darius
Harald
H
Kerber
Sebastian
S
Schumacher
Burghard
B
Grube
Eberhard
E
Hauptmann
Karl Eugen
KE
Glunz
Hans-Georg
HG
Senges
Jochen
J
Zeymer
Uwe
U
D015906:Angioplasty, Balloon, Coronary / Q000706:statistics & numerical data*; D023903:Coronary Restenosis / Q000453:epidemiology* / Q000517:prevention & control*; D054855:Drug-Eluting Stents / Q000706:statistics & numerical data*; D005544:Forecasting; D005858:Germany / Q000453:epidemiology; D006083:Graft Occlusion, Vascular / Q000453:epidemiology* / Q000517:prevention & control*; D006801:Humans; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data* / Q000639:trends*; D014600:Utilization Review