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Better patient outcomes with drug eluting stents
December 18, 2008Drug eluting stents have lower mortality rates compared with bare metal stents in short-term
Patients receiving drug eluting stents (DES) - stents coated with medication to prevent narrowing of the artery - as part of an angioplasty had better outcomes one year later than patients with bare metal stents, according to a new study to be published in CMAJ http://www.cmaj.ca/press/080050.pdf.
Mortality in the first 30 days for people with drug eluting stents was significantly lower than for those with bare metal stents. However, in this prospective cohort study of 6440 patients, there was an increased risk of repeat revascularization procedures or death in the DES group after 3 years.
Patients with drug eluting stents were more likely to be female, with higher rates of kidney disease, diabetes, high cholesterol and hypertension.
"Our study findings suggest that drug eluting stents, despite recent concerns surrounding drug eluting stent safety, the long-term survival (to 3 years) of patients receiving drug eluting stents remains globally favourable, and certainly not measurably worse than that of patients treated with bare metal stents," state Dr. William Ghali, coauthors from the University of Calgary and Dr. Andrew Philpott. "However, we did observe a concerning risk trend toward accelerating adverse events in the DES group late in the follow-up period - a finding that underlines the need for ongoing surveillance of longer-term outcomes," write the authors.
Visit cmaj.ca later this week for a related commentary by Dr. Philippe Généreux and Dr. Roxana Mehran from the Columbia University Medical Center. They also caution that "despite the large amount of favourable long-term data on the use of drug eluting stents from randomized controlled trials, meta-analyses and observational studies, the long-term safety of drug eluting stents, especially regarding late and very late stent thrombosis, remains a major concern."
Canadian Medical Association Journal
Patients with drug eluting stents were more likely to be female, with higher rates of kidney disease, diabetes, high cholesterol and hypertension.
"Our study findings suggest that drug eluting stents, despite recent concerns surrounding drug eluting stent safety, the long-term survival (to 3 years) of patients receiving drug eluting stents remains globally favourable, and certainly not measurably worse than that of patients treated with bare metal stents," state Dr. William Ghali, coauthors from the University of Calgary and Dr. Andrew Philpott. "However, we did observe a concerning risk trend toward accelerating adverse events in the DES group late in the follow-up period - a finding that underlines the need for ongoing surveillance of longer-term outcomes," write the authors.
Visit cmaj.ca later this week for a related commentary by Dr. Philippe Généreux and Dr. Roxana Mehran from the Columbia University Medical Center. They also caution that "despite the large amount of favourable long-term data on the use of drug eluting stents from randomized controlled trials, meta-analyses and observational studies, the long-term safety of drug eluting stents, especially regarding late and very late stent thrombosis, remains a major concern."
Canadian Medical Association Journal
Drug Eluting Stents Current Events and Drug Eluting Stents News RSSSCAAR registry provides reassurance on drug eluting stent safety
A study published today in The New England Journal of Medicine (May 7, 2009) (1), analysed the outcomes of 47,967 patients entered into the Swedish Coronary Angiography and Angioplasty Registry (SCAAR) between 2003 and 2006.
SYNTAX defines borders between CABG and PCI with TAXUS drug-eluting stents
Coronary artery bypass grafting (CABG) should remain the "standard of care" for patients with complex coronary artery disease, concludes the SYNTAX study, published in the New England Journal of Medicine (online February 18, 2009, Print edition March 5).
DES: New elements in the debate
Results announced at the 2006 ESC meeting in Barcelona questioned the long-term safety of drug eluting stents (DES) and sparked intense discussion.
Modified herpes virus keeps arteries 'free-flowing' following procedures
A genetically engineered herpes simplex virus, primarily known for causing cold sores, may help keep arteries "free-flowing" in the weeks following angioplasty or stent placement for patients, according to research published early in the online edition of PNAS (Proceedings of the National Academy of Sciences of the United States of America).
Drug-eluting stents may cause allergic reactions
Drug-eluting stents have greatly reduced the risk of repeat blockage of heart arteries, but researchers from Northwestern Memorial Hospital have found that in some patients, the stents can cause allergic reactions that can have serious consequences.
ESC Congress 2003: ESC Guidelines for Percutaneous Coronary Interventions (PCI)
IMPORTANT: This press release accompanies a presentation given at the ESC Congress 2003. Written by the investigator himself/herself, this press release does not necessarily reflect the opinion of the European Society of Cardiology Background: The non-surgical treatment of severely narrowed coronary arteries (stenosis) has grown tremendously over the last years with now over 1 million procedures world-wide. These procedures are performed through a little skin incision in the groin („percutaneous") to avoid open heart surgery. In contrast to the early days of PCI, where only „plain" balloons were available, there is an increasing number of various additional devices, met
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