title: Use of drug-eluting versus bare-metal stents after an acute coronary syndrome in Portugal: the EURHOBOP study.
abstract: OBJECTIVE
  The interventional cardiologist chooses a specific stent type based on the risk-benefit profile for each case. In general, drug-eluting stents should be considered in all clinical conditions, except if there are concerns or contraindications for prolonged dual antiplatelet therapy. The aim of this work was to describe the use of bare-metal vs. drug-eluting stents in patients undergoing percutaneous coronary intervention (PCI) after an acute coronary syndrome in Portuguese hospitals, according to patients' demographic and clinical characteristics and institutional characteristics.
  
  
  METHODS
  Within the EURopean Hospital Benchmarking Processes (EURHOBOP) study, we retrospectively assessed 3009 consecutive patients in 10 Portuguese hospitals in 2009. Only patients with stents implanted during PCI (n=1194) were analyzed.
  
  
  RESULTS
  A total of 425 patients (36%) received a bare-metal stent and 769 patients (64%) received a drug-eluting stent. A history of previous PCI, current non-ST-elevation myocardial infarction, anterior descending artery as the infarct-related artery and being initially admitted to a hospital with a catheterization laboratory were associated with drug-eluting stent implantation. Age under 45 or over 80, anemia and previous anticoagulation and/or atrial fibrillation were associated with bare-metal stent use.
  
  
  CONCLUSIONS
  Approximately two-thirds of patients received drug-eluting stents, which were less frequently implanted in patients with ST-elevation myocardial infarction, aged over 80 years, female, with a previous history of stroke, anticoagulation and/or atrial fibrillation and anemia. Patients who had previously undergone PCI and those with the anterior descending artery as the infarct-related artery were more likely to receive a drug-eluting stent.
authors.affiliation: Institute of Public Health of the University of Porto (ISPUP), Porto, Portugal. Electronic address: vitorandrebarros@gmail.com.
authors.forename: Vítor
authors.initials: V
authors.lastname: Barros
authors.affiliation: Institute of Public Health of the University of Porto (ISPUP), Porto, Portugal; Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal.
authors.forename: Marta
authors.initials: M
authors.lastname: Pereira
authors.affiliation: Institute of Public Health of the University of Porto (ISPUP), Porto, Portugal; Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal; Department of Cardiology, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal.
authors.forename: Carla
authors.initials: C
authors.lastname: Araújo
authors.affiliation: Department of Cardiology, Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Braga
authors.affiliation: Institute of Public Health of the University of Porto (ISPUP), Porto, Portugal; Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Azevedo
mesh_terms: D054058:Acute Coronary Syndrome / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D011174:Portugal; D011474:Prosthesis Design; D012189:Retrospective Studies; D015607:Stents
keywords: Acute coronary syndrome; Angina instável; Angioplastia coronária; Coronary angioplasty; Enfarte do miocárdio; Myocardial infarction; Stent; Síndrome coronária aguda; Unstable angina