Selection Criteria in the Era of Perfect Competition for Drug-Eluting Stents in Association With Operator Volumes: An Operator-Volume Analysis of the Selection DES Study

在药物洗脱支架完全竞争时代,选择标准与术者手术量之间的关系:一项基于术者手术量选择的DES研究分析

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Abstract

BACKGROUND: This study aimed to explore the factors influencing the drug-eluting stent (DES) selection criteria of cardiologists in association with percutaneous coronary intervention (PCI) volumes and to determine whether they value further DES improvements and modifications. METHODS: The survey was conducted on a group of cardiologist operators from April 10 to 30, 2023. RESULTS: The analysis included 126 operators who answered the questions. Of these, low-, intermediate-, and high-volume operators accounted for 49 (38.9%), 47 (37.3%), and 30 (23.8%), respectively. Overall, Xience™ everolimus-eluting stent (CoCr-EES) was most frequently used, with > 70% of cardiologists using it in > 20% of their PCI practice. The percentage of selection by low-, intermediate-, and high-volume operators among the DESs used demonstrated no difference, except for dual-therapy sirolimus-eluting and CD34(+) antibody-coated Combo(®) stent (DTS). Logistic regression analysis revealed that low-volume operators are less likely to be affected in terms of company/sales representative (odds ratio (OR): 0.402, P = 0.031) and bending lesions (OR: 0.339, P = 0.037) for selecting DES. Low-volume operators less frequently selected Resolute Onyx™ zotarolimus-eluting stents (OR: 0.689, P = 0.043) and DTS (Drug-Eluting Stents) (OR: 0.361, P = 0.006) for PCI. CONCLUSIONS: The current study results indicate that patient background, DES performance, and product specifications were not criteria for DES selection in cardiologists with different PCI volumes in routine PCI.

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