title: Comparison of Clinical Outcomes in Patients Undergoing Coronary Intervention with Drug-Eluting Stents or Bare-Metal Stents: A Nationwide Population Study.
abstract: BACKGROUND
  The aim of this propensity score-matched cohort study was to investigate the prognostic impacts of drug-eluting stents (DES) and bare-metal stents (BMS) in patients undergoing percutaneous coronary intervention (PCI).
  
  
  METHODS
  We conducted a retrospective cohort study based on the National Health Insurance program. Patients who had undergone coronary stenting between Jan. 2007 and Dec. 2008 were recruited and monitored until the end of 2010. Subjects with either BMS or DES were matched 2:1 by propensity score, which adjusted for age, sex, stent number and Charlson comorbidity index (CCI). The Kaplan-Meier method and Cox regression models were used for prognostic analyses.
  
  
  RESULTS
  Among a total of 966 patients with a mean age of 66 years, 644 subjects had BMS and 322 subjects had DES. The incidence of myocardial infarction (MI) and death were significantly lower in the DES group as compared with the BMS group for the three-year follow-up duration. With adjustments for age, sex, premium-based monthly salary, levels of hospital care, stent number, CCI, medications, and acute coronary syndrome presentation in the index hospitalization, use of DES rather than BMS was associated with reduced adverse coronary events (hazard ratio and 95% confidence interval: 0.55, 0.38-0.81 in the whole population, and 0.44, 0.26-0.73 in the subgroup patients with stable coronary artery disease).
  
  
  CONCLUSIONS
  Implantation of DES was related to better outcomes than for BMS, in terms of reducing MI and mortality after PCI. The survival benefit for patients with DES was even greater in patients with stable coronary artery disease.
authors.affiliation: Department of Medicine; ; Cardiovascular Research Center; ; Department of Medicine; ; Department of Public Health.
authors.forename: Shih-Hsien
authors.initials: SH
authors.lastname: Sung
authors.affiliation: Institute of Hospital and Health Care Administration, National Yang-Ming University; ; Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan.
authors.forename: Tzu-Ching
authors.initials: TC
authors.lastname: Chen
authors.affiliation: Department of Medical Education; ; Laboratory of Evidence-Based Healthcare, Taipei Veterans General Hospital; ; Cardiovascular Research Center; ; Department of Medicine; ; Department of Public Health.
authors.forename: Hao-Min
authors.initials: HM
authors.lastname: Cheng
authors.affiliation: Department of Medical Education; ; Laboratory of Evidence-Based Healthcare, Taipei Veterans General Hospital.
authors.forename: Jia-Chun
authors.initials: JC
authors.lastname: Lee
authors.affiliation: Institute of Hospital and Health Care Administration, National Yang-Ming University.
authors.forename: Hui-Chu
authors.initials: HC
authors.lastname: Lang
authors.affiliation: Department of Medical Education; ; Cardiovascular Research Center; ; Department of Medicine; ; Department of Public Health.
authors.forename: Chen-Huan
authors.initials: CH
authors.lastname: Chen
keywords: Bare-metal stent; Drug-eluting stent; Propensity score