28th August 2009
National Guideline Clearinghouse
National Institute for Health and Clinical Excellence
Summary,


DISEASE/CONDITION(S)
Coronary artery disease

GUIDELINE CATEGORY
Assessment of Therapeutic EffectivenessTreatment

CLINICAL SPECIALTY
Cardiology
Internal Medicine
Thoracic Surgery

INTENDED USERS
Advanced Practice Nurses
Nurses
Physician Assistants
Physicians

GUIDELINE OBJECTIVE(S)
To evaluate the clinical effectiveness and cost-effectiveness of drug-eluting stents for the treatment of coronary artery disease

TARGET POPULATION
Adults with coronary artery disease undergoing percutaneous coronary intervention (PCI)

INTERVENTIONS AND PRACTICES CONSIDERED
Drug-eluting stents (DES)

MAJOR OUTCOMES CONSIDERED

• Clinical effectiveness
  Combined event rate (major adverse cardiac events, target vessel failure) or event free survival
  Mortality (all cause and cardiac)
  Acute myocardial infarction
  Target lesion revascularization
  Target vessel revascularization
  Repeat revascularization (percutaneous coronary intervention [PCI]/stent, other PCI or coronary artery bypass grafting [CABG])
  Adverse effects (thrombosis, mal-absorption; incomplete stent apposition; device failures/defects)
  Angiographic binary restenosis
  Late loss
  Health-related quality of life
• Cost-effectiveness