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

ther 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
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