Navigation Links
Drug-Coated Stents Better at Keeping Arteries Open

But they show no lifesaving benefit over bare-metal version, studies show

WEDNESDAY, May 6 (HealthDay News) -- Although arteries propped open by drug-coated stents are less likely to become blocked again than those treated with bare-metal stents, the risk of death and heart attacks is virtually identical between the two devices, major studies in Sweden and the United States show.

The Swedish results eliminate concerns raised by an earlier study that the drug-coated stents might actually be more dangerous, said Dr. Stefan K. James, an associate professor of cardiology at Uppsala University and lead author of the Swedish study appearing in the May 7 issue of the New England Journal of Medicine.

The earlier study, of Swedes given stents in 2003 and 2004, found a higher death rate among those who got the drug-coated kind. The follow-up study of 47,967 Swedes who had stents implanted between 2003 and 2006 found "no overall difference between the group that received drug-eluting stents and the group that received bare-metal stents in the combined endpoint of death or myocardial infarction [heart attack]," the report said.

But the rate of re-stenosis -- new blockage of the treated artery -- was three per 100 patient years versus 4.7 for the bare-metal recipients.

So the earlier result was "just a scary signal" that proved to be false, James said.

"For me, this paper shows that there should now be no real concerns about the safety of drug-eluting stents and that the emphasis should shift back to considering the relative efficacy of drug-eluting stents and bare-metal stents," Dr. Eric Eeckhout, a spokesman for the European College of Cardiology, said in a statement.

James's interpretation of the study is that use of drug-coated stents should be limited to cases where the risk of re-stenosis is high -- when the blockages are in smaller blood vessels and are long in length and when the person has diabetes, for example.

Cost plays a role in his judgment, James said. "The prices of drug-coated stents have gone down in Europe, but they cost twice as much here [in Europe] as the bare-metal stents," he said.

And the study results are not definitive because they did not come from a randomized, controlled trial, the gold standard of medical research, James said.

The American study, reported in the same journal, was such a controlled trial. It included 3,006 people given stents after heart attacks, comparing outcomes for the 2,257 who got Taxus stents, coated with the drug paclitaxel, with the 749 who received bare-metal stents.

Unlike the Swedish trial, which was funded by governmental and noncommercial organizations, the American trial was supported by Boston Scientific, which markets the Taxus stent.

Again, the rate of re-stenosis was significantly lower in the group given a coated stent: 10 percent versus 22.9 percent in the first 13 months. There was an identical 12-month death rate, 3.5 percent, in both groups, and no difference in the incidence of serious cardiac problems, such as second heart attacks.

It's not surprising that there was no lifesaving benefit to the drug-eluting stent, said study author Dr. Gregg W. Stone, a professor of medicine at Columbia University Medical Center.

The procedure done in the study was the reopening of the blocked artery that caused the heart attack, Stone said. "What keeps them alive is whether or not they have another heart attack," he said. "We don't expect them [the stents] to save lives."

He was strict in drawing a conclusion from the trial: "What this study shows is that this paclitaxel-eluting stent is safe to use in patients with an evolving heart attack, and that it reduced the incidence of re-stenosis by about 40 percent."

That conclusion cannot be extended to other drug-coated stents because "drug-eluting stents are different from each other," Stone said. Another controlled trial would be needed to determine whether the differences are significant in ultimate results, he noted.

More information

The U.S. Food and Drug Administration has more on stents.

SOURCES: Stefan K. James, M.D., Ph.D., professor, cardiology, Uppsala University, Sweden; Gregg W. Stone, M.D., professor, medicine, Columbia University Medical Center, New York City; May 7, 2009, New England Journal of Medicine

Copyright©2009 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Drug-Coated Sponges May Limit Catheter Infections
2. UT Southwestern researchers find drug-coated stents less risky for heart bypass patients
3. Drug-Coated Stents Reduce Repeat Artery Procedures
4. More patients with drug-coated cardiac stents survive, avoid costly follow-up procedures
5. Drug-Coated Stents Still Spark Debate
6. New Drug-Coated Stent Does Well in Early Trial
7. Drug-coated balloon overcomes in-stent restenosis
8. Drug-Coated Balloons Keep Leg Arteries Open: Study
9. Drug-Coated Stents Better Than Bare-Metal Ones in Complex Cases
10. Drug-Coated Stents No Riskier in Long Run Than Bare Metal Ones
11. Study Finds Benefits With Drug-Coated Stents
Post Your Comments:
Related Image:
Drug-Coated Stents Better at Keeping Arteries Open
(Date:6/26/2016)... Cary, North Carolina (PRWEB) , ... June 26, 2016 , ... ... the release of a new product that was developed to enhance the health of ... harvested for centuries. , The two main herbs in the PawPaws Cat Kidney ...
(Date:6/25/2016)... ... ... temporary closing of Bruton Memorial Library on June 21 due to a possible lice infestation, ... aspect of head lice: the parasite’s ability to live away from a human host, and ... necessary one in the event that lice have simply gotten out of control. , As ...
(Date:6/25/2016)... ... ... Friday, June 10, Van Mitchell, Secretary of the Maryland Department of Health and Mental ... exemplary accomplishments in worksite health promotion. , The Wellness at Work Awards took place ... BWI Marriott in Linthicum Heights. iHire was one of 42 businesses to receive an ...
(Date:6/24/2016)... ... ... crisis. Her son James, eight, was out of control. Prone to extreme mood shifts and ... him, he couldn’t control his emotions,” remembers Marcy. “If there was a knife on ... say he was going to kill them. If we were driving on the freeway, ...
(Date:6/24/2016)... ... ... BioMedics, Inc, makers of Topricin and MyPainAway Pain Relief Products, join The ‘Business for a ... an hour by 2020 and then adjusting it yearly to increase at the same rate ... assure the wage floor does not erode again, and make future increases more predictable. , ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... -- Research and Markets has announced the addition ... - Forecast to 2022" report to their offering. ... to date financial data derived from varied research sources to ... potential impact on the market during the next five years, ... of sub markets, regional and country level analysis. The report ...
(Date:6/23/2016)... Research and Markets has announced the ... report to their offering. ... favourable commercial environment for MedImmune to enter. The US ageing ... serve to drive considerable growth for effective anti-influenza medications. The ... sales considerably, but development is still in its infancy. ...
(Date:6/23/2016)... , June 23, 2016 , ... on Thursday, July 7, 2016 , , , , LOCATION: ... , , , , EXPERT PANELISTS:  , , , ... Senior Industry Analyst, Christi Bird; Senior Industry Analyst, Divyaa Ravishankar and ... The global pharmaceutical industry is witnessing an exceptional era. ...
Breaking Medicine Technology: