SOURCE: VHA

February 23, 2010 10:33 ET

Clinical Effectiveness Study Relies Exclusively on Information From VHA's CathSource® Database

Data Facilitates Scientific Decisions, Enables Evidence-Based Conclusions

IRVING, TX--(Marketwire - February 23, 2010) -  In a recent Journal of Invasive Cardiology study, VHA's CathSource database provided the information necessary to better understand treatment options for coronary artery disease. The article, "Repeat Coronary Revascularizations after Successful Bare-Metal or Drug-Eluting Stent Implantation," appeared in the journal's January 2010 issue. VHA Inc. is a national health care network serving more than 1,400 not-for-profit hospitals and health care systems.

As the nation grapples with health care reform efforts, comparing the outcomes of treatment options is critical to providing quality, cost effective health care.

Written by Cynthia A. Yock, J. Michael Isbill, MS, Spencer B. King III, MD and Mark A. Hlatky, MD, the paper examines the frequency of repeat procedures to re-open clogged stents among patients who received coronary bare-metal stents or the newer drug-eluting stent. The authors evaluated catheterization laboratory data from 31 participating hospitals. 

They looked at data from nearly 15,000 patients who received bare-metal stent implants between 1998-2003 and 9,575 patients who received drug eluting stents at 20 hospitals during 2005.

Randomized trials had indicated that the repeat procedure rate for people with drug-eluting stents was substantially lower than that for bare-metal stents. This study found, however, that the overall rate of repeat stenting procedures for bare-metal in real-world situation was not appreciably different from those after drug-eluting stenting after one year. The authors also found that drug-eluting stent patients were much more likely to be readmitted to the hospital for additional procedures to treat arteries that had not been stented during the first procedure.

"The large repository of detailed angiographic data from VHA's CathSource database made possible this study of stent outcomes," said Stanford Health Policy fellow Cynthia Yock, the study's lead author. "We were able to discern the anatomical reason for repeat procedures and determine whether the original stent had re-narrowed and was the target of subsequent interventions."

The Journal of Invasive Cardiology article exemplifies comparative effectiveness research -- it expands the body of information available about coronary artery disease treatment options. 

Given the increased cost to adopt drug-eluting stents, on average $1,973 per procedure for the devices alone, this study further concludes that in order to focus use of the more expensive stents we need to better understand which patients respond best to either bare-metal or drug-eluting stents. Importantly, since stents are physician preference items that hospitals pay for directly, reducing the cost for thousands of stent procedures could result in considerable systemic savings. 

"We have to have products that work for patients," said Joane Goodroe, VHA senior vice president of Innovation. "This study validates the utility and value of VHA's data warehouse to facilitate the study of patient outcomes and comparative effectiveness." 

About VHA

VHA Inc., based in Irving, Texas, is a national network of not-for-profit health care organizations that work together to drive maximum savings in the supply chain arena, set new levels of clinical performance and identify and implement best practices to improve operational efficiency and clinical outcomes. Formed in 1977, VHA serves more than 1,400 hospitals and more than 28,000 non-acute care providers nationwide.

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