Large Study Gives Nod to Drug-Eluting Stents in He...(tients are already prone to formingblood...),Health

To evaluate the long-term safety and effectiveness of drug-eluting stents, Dr. Mauri and her colleagues analyzed data from 7,216 patients who underwent stenting for acute MI in Massachusetts, where hospitals are required to submit data on all coronary interventions to a state database. Of these, 4,016 patients were treated with a drug-eluting stent and 3,200 were treated with a bare-metal stent. To adjust for differences in baseline risk, patients in the two groups were matched on up to 63 variables.

Researchers found that the two-year, risk-adjusted rate of revascularization -- or the need for a repeat procedure to open the coronary arteries as a result of renarrowing, or restenosis -- was significantly lower in patients treated with drug-eluting stents when compared with bare-metal stents (15.5 percent vs. 20.8 percent; p<0.001). Mortality was 10.4 percent and 13.2 percent, respectively, in the two groups (p=0.002), and repeat MI occurred in 9.5 percent and 11.0 percent, respectively (p=0.08).

"These findings are reassuring," Dr. Mauri said. "Although neither bare-metal stents nor drug-eluting stents were originally approved in the setting of acute myocardial infarction, it is probably the most important condition we treat with stents. I would feel comfortable considering drug-eluting stents on the basis of these results -- with the caveats that treated patients must be able to take antiplatelet therapy and that we definitely want to see even longer-term follow-up."

The researchers plan to continue follow-up in Massachusetts and re-examine the findings when more data are available.

Dr. Mauri will present the results of this study on Sunday, March 30 at 9:15 a.m. CDT in the Grand Ballroom, S100.

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