Navigation Links
An 'important' reduction in risk of stent thrombosis with everolimus-eluting stent

Results of the independently-funded Bern-Rotterdam cohort study provide robust evidence of an "important" reduction in overall and very late stent thrombosis. The reduction in incidence was found when a newer generation everolimus-eluting stent (EES) was compared with early generation drug-eluting stents (DES) at long-term follow-up.

"The near elimination of stent thrombosis observed between one and four years after implantation shows that everolimus-eluting stents overcome the principal limitation of early generation DES," said investigator Dr Lorenz Rber from the University Hospital of Bern, Switzerland. "This an important advance in the safety of DES."

As background to the study, Dr Rber notes that the introduction of DES, which release anti-proliferative drugs from a polymer on the stent surface to prevent the formation of excessive scar tissue within the metallic scaffold (restenosis), was an important advance in the field of interventional cardiology, as revascularisation due to restenosis was significantly decreased. However, after the introduction of DES, data indicated that the formation of normal scar tissue was occasionally inhibited to such an extent that the stents were left uncovered. This was partly explained by inflammatory reactions against the polymer coating, presdisposing to stent thrombosis.

Although rare, stent thrombosis is a serious complication, which may result in death or acute myocardial infarction. Stent thrombosis occurring more than one year after implantation commonly referred to as very late stent thrombosis (VLST) has been observed more frequently in patients treated with early generation DES releasing the drugs paclitaxel or sirolimus than with bare metal stents and has emerged as a distinct entity complicating their use. The Bern-Rotterdam group has previously reported a steady annual risk of VLST of 0.6% up to five years following the implantation of early generation DES, a finding that has been confirmed by other trials and meta-analyses.

It is against this background that newer generation DES, such as everolimus-eluting stents, have been developed, to improve safety with the application of a more biocompatible polymer, along with a reduction in drug dose and reduced strut thickness. Whether these changes in design are sufficient to overcome VLST - the principal limitation of early generation DES - is to date not known.

The Bern-Rotterdam cohort study included more than 12,000 patients treated between 2002 and 2009 at the Bern University Hospital in Switzerland and the Thoraxcenter at Erasmus Medical Centre in Rotterdam, The Netherlands. The objective was to compare the incidence of stent thrombosis between newer generation DES eluting everolimus, and early generation DES eluting srolimus or paclitaxel, with particular focus on stent thrombosis occurring between one and four years (VLST).

Results showed that the rate of stent thrombosis up to four years was lower among patients treated with everolimus-eluting stents (1.4%) than with sirolimus-eluting stents (2.9%, p<0.0001) and paclitaxel-eluting stents (4.4%, p<0.0001). The reduction in stent thrombosis was most prominent between one and four years, resulting in a 67% risk reduction in VLST for the comparison of everolimus-eluting with sirolimus-eluting stents, and a 76 % risk reduction for the comparison of everolimus-eluting with paclitaxel-eluting stents.

Commenting on the results, Dr Rber said: "For the first time we now have robust evidence of the long-term therapeutic benefit of newer generation DES over the early generation DES. The virtual elimination of VLST in our findings provide reassurance of the long-term safety of these devices."


Contact: Jacqueline Partarrieu
European Society of Cardiology

Related medicine news :

1. Study finds important risk factors for death/transplantation in children with heart muscle disease
2. Dolphins remarkable recovery from injury offers important insights for human healing
3. Vascular disease management increasingly important
4. Family meals remain important through teen years, expert says
5. Concussion baseline important for accurate future assessment in at-risk youth athletes
6. Canadas Cancer Risk Management model is an important new health tool for policymakers
7. Freedom More Important to Happiness Than Wealth, Study Finds
8. Important monitoring of heart performance is omitted in two-thirds of high-risk surgical operations
9. Mothers Play Important Role in Recovery From Mental Illness
10. Important info about CHIPRA core set of recommended health care quality measures released
11. Ohio residents: Medical and health research important to states economy, jobs and incomes
Post Your Comments:
(Date:10/12/2017)... ... , ... IsoComforter, Inc. ( ), one of the Nation’s ... design of the shoulder pad. The shoulder pad provides optimal support and full ... while using cold therapy. By utilizing ice and water that is circulated from an ...
(Date:10/12/2017)... (PRWEB) , ... October 12, 2017 , ... ... drug delivery system that we intend to develop to enable prevention of a ... lead to severe hearing loss, especially in pediatric patients. For cisplatin, hearing loss ...
(Date:10/12/2017)... ... October 12, 2017 , ... Leading pediatric oncology experts ... Washington, D.C., for the 49th Congress of the International Society of Paediatric Oncology ... of the Center for Cancer and Blood Disorders at Children’s National, and ...
(Date:10/12/2017)... (PRWEB) , ... October 12, 2017 , ... ... (HLA), the nation's first interactive health literacy software tool, and the Cancer Patient ... aspects of cancer patient education, today announce a new strategic alliance. , ...
(Date:10/12/2017)... ... October 12, 2017 , ... Farm ... California Berkeley, and other leading institutions in announcing the launch of the ... change the way animals are raised for food. , Founding members of the ...
Breaking Medicine News(10 mins):
(Date:10/2/2017)... ORLANDO, Fla. , Oct. 2, 2017  AllianceRx ... services company formed by Walgreens and pharmacy benefit manager ... of its new brand, which included the unveiling of ... Fla. , as well as at a few ... introduces the new brand to patients, some of whom ...
(Date:10/2/2017)... COPENHAGEN, Denmark , Oct. 2, 2017 The ... tool in the struggle to reverse the tide of prescription ... plan for regulating their medicine intake and stepping down their ... is set to launch in December 2017; the first 100,000 ... access. Learn more at ...
(Date:9/28/2017)... 28, 2017 Cohen Veterans Bioscience and Early ... of wearable and home sensors for real-time monitoring of ... Foundation, a nonprofit organization focused on disruptive health solutions ... affordable analytical system to record and integrate behavioral, cognitive, ... ...
Breaking Medicine Technology: