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Knowledge Transfer Gap Between Cardiologists and Patients Undergoing Percutaneous Coronary Intervention Regarding Risks Associated With Drug-Eluting Stents: An Asian & European Survey

      Objectives

      The choice of stent used in percutaneous coronary intervention (PCI) is often at the discretion of the interventional cardiologist (IC) without informed shared decision making. We aim to assess the impact of ICs’ awareness of the risk of delayed arterial healing associated with drug-eluting stents (DES) on patient knowledge transfer.

      Methods

      132 ICs from 11 countries (3 Asian: Malaysia, Hong Kong, Singapore and 8 European: Germany, Italy, UK, The Netherlands, Belgium, Denmark, Russia and Serbia) were invited to complete an online survey using a 4-point scale regarding their (i) familiarity with delayed arterial healing associated with DES; (ii) how concerned they are about delayed arterial healing; (iii) frequency they discuss this risk with their patients and (iv) frequency this risk influence the type of stent they use. Responses from Asian cardiologists were compared with Europeans.

      Results

      43.2% ICs were Asians and 56.8% were Europeans. Majority of IC were extremely/very familiar with the risk of delayed arterial healing after DES implantation (63.2% Asian vs. 56.0% European, p=NS). IC who were extremely/very concerned about the risk of delayed healing were more likely to discuss with their patients (Odds Ratio (OR) 2.62,95% confidence interval (CI) 1.17-5.85, p<0.01) and influence their stent choice (OR 5.56,95%CI 2.56-12.05, p<0.01). Although twice as many Asian compared to European ICs were extremely/very concerned about delayed arterial healing with DES (59.6% vs. 32.4%, respectively, p<0.01), there were no significant differences in the frequency this risk was discussed with patients (often/always: 24.6% Asian vs. 26.7% European, P=NS) or influence the type of stent used (often/always: 47.4% vs. 35.7%, P=NS).

      Conclusions

      Many patients are not well informed of the risk associated with DES despite high level of physician awareness and concern of this risk. This knowledge transfer gap exists in both Asia and Europe.