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Drug-Coated Stents Go Head to Head
Date:9/13/2007

Data analysis suggests sirolimus-coated model is safer

THURSDAY, Sept. 13 (HealthDay News) -- A survey of trials of drug-coated stents finds that those coated with the medication siromilus appear to be somewhat safer than those coated with another drug, paclitaxel.

Analysis of 38 trials involving more than 18,000 participants suggest that "sirolimus-eluting stents appear to have the best overall profile, if you look at the entire picture," said lead researcher Dr. Peter Juni, head of the division of clinical epidemiology and biostatistics at the University of Bern in Switzerland.

There was one caveat, however: According to Juni, the studies were so varied in the types of patients given stents -- tiny mesh tubes that prop open arteries -- that it's not possible to say that everyone would be better off with a siromilus-coated model.

"We need to better understand if there are subgroups that benefit more from siromilus-eluting stents or perhaps subgroups that do not benefit at all from them," he said. "Future studies need to address the problem of the patient spectrum."

The difference was confined to the risk of heart attacks and restenosis -- a re-blockage of the reopened artery -- after the stents were implanted, said the report, which is published in the Sept. 15 issue of The Lancet.

The researchers also noted that the patient death rate was the same for those who got either one of the more expensive drug-coated stents, or a bare-metal stent.

However, the incidence of heart attacks was 19 percent lower in those getting a siromilus-coated stent than those getting a bare-metal stent, the team found. Heart attack risk was 17 percent lower in those getting the paclitaxel stent compared to the use of bare-metal devices.

The report may help settle the ongoing battle between the two stents, "mainly because the data set is so big," said Dr. Kirk Garratt, clinical director of i
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