Drug-Eluting Stents Lead To Better Patient Outcomes In The Short Term

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Main Category: Cardiovascular / Cardiology
Also Included In: Heart Disease;  Medical Devices / Diagnostics
Article Date: 19 Dec 2008 - 0:00 PDT

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According to a new study published in the Canadian Medical Association Journal, angioplasty patients who received drug-eluting stents had lower short-term mortality rates than those who received bare-metal stents.

Drug-eluting stents (DES) are medication-coated tubes that are inserted into the body to prevent constriction or narrowing of a conduit such as an artery. For years it was standard practice for patients to receive bare-metal stents, but recent research has highlighted the superiority of drug-eluting stents. This recent study by Dr. William Ghali, Dr. Andrew Philpott, and colleagues from the University of Calgary finds that angioplasty patients had better outcomes one year later if they received DES rather than bare-metal stents.

The study consisted of 6,440 patients, 1,120 who received DES and 5,320 who received bare-metal stents during angioplasty. The patients who received DES were more likely to be female and had higher rates of kidney disease, diabetes, high cholesterol, and hypertension (high blood pressure). During the first 30 days after surgery, patients with drug-eluting stents had significantly lower mortality compared to those with bare-metal stents. However, the researchers note that patients who received DES had a greater risk of repeat revascularization procedures or death after 3 years.

"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 favorable, and certainly not measurably worse than that of patients treated with bare metal stents," state the authors of the study. "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."

A related commentary written by Dr. Philippe Généreux and Dr. Roxana Mehran (Columbia University Medical Center, New York) warns that, "Despite the large amount of favorable 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."

Long-term outcomes of patients receiving drug-eluting stents
Andrew C. Philpott MD, Danielle A. Southern MSc, Fiona M. Clement PhD, P. Diane Galbraith BN MSc, Mouhieddin Traboulsi MD, Merril L. Knudtson MD, William A. Ghali MD, for the APPROACH Investigators
CMAJ (2008); 180(2).
doi:10.1503/cmaj.080050
Click Here to View Journal Website

Written by: Peter M Crosta
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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