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Are Drug-Coated Stents Safe and Effective? Study Says Yes

Posted by Jane Akre
Thursday, May 07, 2009 11:00 AM EST
Category: Major Medical, Protecting Your Family
Tags: Boston Scientific, Drug-Eluting Stents, Heart Attack, Cardiac Disease, Cholesterol, Heart Plaque

Drug-eluting stents found to be less likely to clogg in this NEJM study.  

Are Drug-Coated Stents Safe 

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IMAGE SOURCE:  Boston Scientific Web site/ Taxus Express Coronary Stent System

 

The controversy has been ongoing for cardiac patients confused whether to choose more expensive heart stents coated with drugs or those without.

Swedish researchers, in a published study Wednesday, conclude that drug-eluting stents are just as safe as uncoated one, and in fact may keep the blood flow to the heart muscle longer than the uncoated variety.  

This is the same Swedish team that caused a firestorm in 2006 when it reported that the drug-eluted stents were more likely to cause an increase in the death rate – about 18 percent within three years. 

The earlier report put Boston Scientific and Johnson & Johnson sales into a tailspin that amounted to a $1 billion loss. 

Now long-term results of nearly 48,000 patients from the Uppsala University Hospital in Sweden, put the death rate between drug-eluting stents or bare-metal stents about even.

Patients with drug-coated stents, even high-risk patients, had a 74 percent lower risk of experiencing a clogged stent compared to bare metal. . 

The results are published in the current issue of the New England Journal of Medicine (NEJM).

Why the different results?

Speaking to Physorg.com, Professor Eric Eeckhout, a spokesman for the European Society of Cardiology, says,   "The difference in outcome is likely to be a reflection of the way in which cardiology practice has evolved over time, leading to greater optimisation of the results of stenting. Significant changes include use of higher balloon pressures and the increased use of dual anti-platelet therapy."

Another smaller study in the same issue of the NEJM from Columbia University Medical Center, found drug coated stents did a better job than bare ones in helping blood flow freely, although in heart attack patients there was no difference in the risk of death or heart attack. 

That study was supported partially by a grant from Boston Scientific and finds the drug-eluting stent does a better job than bare-metal stents of keeping blood vessels flowing freely.

"Our study is in the highest-risk patients and it's a randomized trial. The Swedish study is important because it's a 'real-world' study that included all comers," Dr. Gregg Stone of Columbia University Medical Center said in a telephone interview with the Boston Globe.

Dr. Stone reports after a year, 10 percent of the blood vessels held open by the Taxus stents had clogged up by at least 50 percent, reports boston.com.   Meanwhile 23 percent of the bare stents clogged. 

Boston Scientific reports that the TAXUS stent uses a polymer to control release of the drug, paclitaxel.

The only downside is the cost.  Drug-coated stents are significantly more expensive and in the short run do not appear to help people live longer.  #


1 Comment

Posted by Jane Akre
Thursday, May 07, 2009 2:55 PM EST

For those of you interested in any conflicting interests here between the authors and medical device companies .... Here is the statement that accompanies the NEJM article!!

"Supported by grants from the Swedish Association of Local Authorities and Regions and the Swedish Heart-Lung Foundation (to SCAAR and the Uppsala Clinical Research Center) and the Swedish Board of health and Welfare and the Swedish Medical Products Agency.

"Dr. James reports receiving lecture fees from Boston Scientific, Cordis, and Eli Lilly; and Dr. Schersten, consulting fees from Medtronic. No other potential conflict of interest relevant to this article was reported."

Comments for this article are closed.

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