Navigation Links
Coated Stents Best for Heart Patients With Diabetes
Date:11/10/2008

Were safer, more effective than bare metal ones, study shows

MONDAY, Nov. 10 (HealthDay News) -- Drug-coated stents appear to be superior to bare metal stents in both efficacy and safety in patients with diabetes, new research shows.

"I would say consistently from randomized trials that there is clear efficacy and clear reduction for repeat revascularization procedures [with drug-coated stents]," said senior study author Dr. Laura Mauri, an assistant professor of medicine at Brigham and Women's Hospital and Harvard Medical School. "That is now also augmented by the fact that there is excellent safety in patients who have a similar ability to take dual antiplatelet therapy."

"That's an important caveat," Mauri added. "I think we have to judge our patients and get to know them as individuals and make determinations on a case-by-case basis. I wouldn't make a blanket statement, but, in general, there is great benefit to the use of drug-eluting stents in diabetic patients, and there does not seem to be a trade-off."

Mauri presented the findings Monday at the American Heart Association's (AHA) annual scientific sessions in New Orleans.

The safety of drug-coated stents versus conventional bare metal stents has been a matter of controversy for years.

Diabetics have a higher prevalence of ischemic heart disease than the general population, but percutaneous coronary intervention (PCI) has limitations in this group, including a higher rate of restenosis and subsequent heart attack and death.

"There is controversy regarding selecting PCI as a treatment for patients with diabetes," said Dr. David Williams, with Brown University and Rhode Island Hospital in Providence. "One of the major shortcomings of PCI in this patient subset has been a relatively high need to perform repeat revascularization. Drug-eluting stents may offer a potential advantage in that regard, but there is some concern as to whether they are as safe as bare metal stents."

Mauri presented three-year follow-up data for a subgroup of about 5,000 diabetic patients undergoing PCI with stenting to reopen blocked vessels.

Two-thirds of the patients were treated with drug-eluting stents, and one-third were treated with bare metal stents.

There was an absolute reduction of around 5 percent in the need for repeat procedures in the target vessel and a small, but significant and surprising, decrease in death and subsequent heart attacks.

"It's appropriate to conclude that drug-eluting stents are superior to bare metal stents in patients with diabetes in regard to reducing the need for repeat revascularization. It also appears to be safe," Williams said. "Whether there's actually a benefit in terms of death and heart attack, I would say this is a provocative finding but not firmly established. This report indicates that probably the selection of bare metal stents over drug-eluting stents will be based on the ability of patients to take dual antiplatelet therapy for a sustained period of time."

A second study, from French researchers, presented at the meeting detailed a way to give individually tailored doses of Plavix (clopidogrel) to patients who had undergone PCI that still reduced the risk of blood clots.

Plavix is a notoriously tricky drug to deliver, as individual responses vary tremendously.

"We prescribe clopidogrel in a one-size-fits-all approach," explained AHA spokeswoman Dr. Nieca Goldberg. "They were looking at a way to individualize the drug."

"The message is 'yes, we can perform a therapeutic window for platelet therapy to avoid MACE [major adverse cardiovascular events] in patients," said senior study author Dr. Franck Paganelli, a professor of medicine in the division of cardiology at Hopital Nord, University of Marseille School of Medicine, in France.

"Trying to identify a loading dose using a lab test is a very creative idea," said AHA spokesman Dr. Elliott Antman. "We have to have a lot more information about the integrity of lab tests and how we should use them."

The authors of this study based their dosing on an index of platelet activity in patients undergoing stent placement.

More information

The American Heart Association has more on PCI.



SOURCES: Nov. 10, 2008, news conference with Laura Mauri, M.D., assistant professor, medicine, Brigham and Women's Hospital and Harvard Medical School, Boston; David Williams, M.D., Rhode Island Hospital and Brown University, Providence; Franck Pagnelli, M.D., Ph.D., professor, medicine, division of cardiology, Hopital Nord, University of Marseille School of Medicine, France; Elliott Antman, M.D., Brigham and Women's Hospital and Harvard Medical School, Boston; Nieca Goldberg, M.D., American Heart Association spokeswoman and clinical associate professor, medicine, and medical director, Women's Heart Program, New York University


'/>"/>
Copyright©2008 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Drug-Coated Stents Go Head to Head
2. Study Finds Benefits With Drug-Coated Stents
3. New Canadian study finds drug coated heart stents to be safe:
4. Starpharma and Durex Sign Co-Development Agreement for VivaGel(R)-Coated Condoms
5. Drug-Coated Stents No Riskier in Long Run Than Bare Metal Ones
6. Study Finds Both Coated Stents Perform the Same
7. Drug-Coated Stents Better Than Bare-Metal Ones in Complex Cases
8. Drug-Coated Balloons Keep Leg Arteries Open: Study
9. Drug-coated balloon overcomes in-stent restenosis
10. New Drug-Coated Stent Does Well in Early Trial
11. Perrigo Receives FDA Approval to Market Orange, Coated Nicotine Gum
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Coated Stents Best for Heart Patients With Diabetes
(Date:6/27/2016)... ... June 27, 2016 , ... ... payment industry today announced its strategic partnership with Connance, a healthcare industry ... The two companies’ proven, proprietary technology combine to provide health systems, hospitals ...
(Date:6/27/2016)... ... 2016 , ... TopConsumerReviews.com recently awarded their highest five-star rating to Best Buy ... in the United States and Canada wear eyeglasses. Once considered to be a purely ... make a fashion statement. Even celebrities use glasses as a way of creating an ...
(Date:6/26/2016)... Battle Creek, Michigan (PRWEB) , ... June 26, 2016 , ... ... abuse, joined as sponsor of the 2016 Cereal Festival and World’s Longest Breakfast Table ... held in honor of the city’s history as home to some of the world’s ...
(Date:6/26/2016)... (PRWEB) , ... June 26, 2016 , ... PawPaws ... a new product that was developed to enhance the health of felines. The formula ... , The two main herbs in the PawPaws Cat Kidney Support Supplement ...
(Date:6/26/2016)... Lake Orion, Clarkston, Michigan (PRWEB) , ... June ... ... direction with respect to fertility once they have been diagnosed with endometriosis. These ... tolerable intercourse but they also require a comprehensive approach that can help for ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... June 24, 2016  Collagen Matrix, Inc., ("Collagen ... and manufacturing of collagen and mineral based medical ... that Bill Messer has joined the ... further leverage the growing portfolio of oral surgery, ... Bill joins the Collagen Matrix executive team ...
(Date:6/24/2016)... , June 24, 2016 ... the "Structural Electronics 2015-2025: Applications, Technologies, Forecasts" ... In-Mold Electronics, Smart Skin, Structural ... Structural electronics involves electronic and/or ... protective structures, replacing dumb structures such as vehicle ...
(Date:6/24/2016)... Research and Markets has announced the ... Tests" report to their offering. ... The World Market for Companion Diagnostics covers the ... analysis in the report includes the following: ... Kits) by Region (N. America, EU, ROW), 2015-2020 , ...
Breaking Medicine Technology: