Drug-eluting stents (DES) have been shown to reduce the risk of restenosis post coronary intervention compared with conventional stents (CS). However, the cost of DES is significantly higher than CS. OBJECTIVE: To evaluate the utilization of DES along with clinical indications, outcomes and cost impact within the cardiac catheterization lab. METHODS: Demographic, clinical and angiographic data were collected retrospectively on all patients who underwent DES implantation between October 15, 2002 and April 15, 2003. Cost data, specifically stent costs, were collected concurrently. RESULTS: A cohort of 46 patients was treated with DES, involving 52 vessels and utilizing 62 stents (56 Cypher, 6 Taxus). Indications for coronary intervention were stable angina (67.2%) and ACS/post MI (32.6%). Indications for DES use included clinical reasons such as diabetes mellitus (15.2%), prior bypass surgery (19.6%) and renal insufficiency (8.7%). Angiographic indications included: stenosis length >18mm (43.4%), vessel diameter < 2.5mm (32.6%), patients with multivessel disease (21.7%) and instent restenosis (8.7%). Short-term clinical complications included death but no strokes or myocardial infarctions. The procedural success was 95.8% (44/46), and the clinical success was 92.5% (43/46). The average number of DES per patient was 1.35. During the same time period, 351 patients were treated with CS, utilizing 522 stents. The average number of stents per patient was 1.48. The total hospital-incurred DES cost was $227,500 for an average stent cost $4945.65 per patient. In the CS group the total cost for stents was $496,050 for an average cost of $1413.25 per patient. The average stent cost per patient was 3.5 times higher in the DES group than with CS. CONCLUSIONS: 1) Indications for DES use are consistent with individuals at higher risk for restenosis; 2) The procedural costs for treating these individuals are significantly greater; and 3) Full 6 month outcomes and cost data will be available for presentation.