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Drug-Coated Stents Better Than Bare-Metal Ones in Complex Cases
Date:2/4/2008

Survival advantage found in 'off-label' uses, report suggests

MONDAY, Feb. 4 (HealthDay News) -- Drug-coated stents are better than the bare-metal kind for treating complex arterial blockages, new research finds.

"There are two messages I would take away from the study," said Dr. Robert J. Applegate, a professor of cardiology at Wake Forest University and lead author of a report in the Feb. 12 issue of the Journal of the American College of Cardiology. "The first is that drug-eluting stents are very effective. They were effective in the kind of patients in the initial trials, with simpler problems. Then their effectiveness was broadened to all patients who underwent stent treatment, even in off-label use. All the benefits present in the early trials are showing in the patients that have these high-risk features."

High-risk factors include diabetes, kidney failure, a recent heart attack and longer blockages, Applegate said. "All of these have been matters of concern about the use of drug-eluting stents. We saw them to be effective in these patients."

The study compared results of 1,285 people with such complications who got drug-coated stents, flexible tubes implanted to keep blood vessels open after the clot-removing procedure called angioplasty and 1,164 people who had bare-metal stents. After two years, the incidence of nonfatal heart attacks or deaths was 29 percent lower for those getting drug-coated stents.

The drug-coated stents were also safer, with the incidence of stent-caused clotting roughly half that seen in the bare-metal stent recipients.

Another study reported in the same issue of the journal was more cautious about the long-term effectiveness of drug-coated stents. The study of 310 people who got stents after heart attacks found that those who got drug-coated stents were better off after a year than those getting bare-metal stents, but that there were worrying indication
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