Study Shows How Fast Data Dissemination Led to Rapid Change in DES Use

Dr. Roe stated that, with the rapid-fire release of data, studies presented at medical conferences in the age of instant information can have an almost immediate impact on patient treatment. The investigators were interested in whether practice patterns changed after the presentation of these studies, and from their findings, they concluded that was the case.

According to the AHA, in September 2006, a number of studies were presented at the European Society of Cardiology scientific sessions that found drug-coated stents were associated with a higher risk of late stent thrombosis, compared with bare-metal stents. Dr. Roe and colleagues examined data from two large patient registries that showed that from January to September 2006 (before the data were released) about 90% of patients with non ST-elevation myocardial infarction (NSTEMI) who underwent coronary stent implantation received drug-eluting stents. By the end of March 2007, the use of drug-eluting stents decreased to 67%, and usage continued to drop to 58% by the beginning of 2008, the investigators reported.

In the study, the investigators examined records of 54,662 patients with NSTEMI, which included 27,329 patients who had stents implanted. The information was gathered from two large registries: CRUSADE during 2006, which transitioned into the ACTION Registry–GWTG beginning in January 2007. Hospital or patient characteristics did not change during the study. The study concluded that the swiftness in which practice patterns changed signaled that speedy distribution of information through media and scientific outlets may become the predominant stimulus for changes in practice in the future.

"There was a rapid change of practice patterns after these presentations in September 2006," commented Dr. Roe. "To our knowledge, this was the most rapid change in practice patterns in cardiology. We presume it was because of a rapid uptake of information. The study's results show the need for experts to put results in context."

AHA President Clyde W. Yancy, MD, added, "This study demonstrates the dynamic shifts that are occurring in the distribution of medical information. The opportunity to widely share important findings that promptly impact practice is becoming a powerful tool to drive change. The requirements for prompt but thorough peer review and nimble responsiveness to new data are evident. Managing this new health IT space will require focus, assessment, and realignment."