Stents May Not Increase Patient Survival
Study: Tiny Tubes Don't Extend Life After Angioplasty Operation
Nov. 8, 2004 -- Stents cut a patient's risk of having a repeat balloon angioplasty to clear a clogged artery. But patients who get stents don't survive any longer than those who don't get them.
The finding comes from a study of patients who underwent balloon angioplasty between 1990 and 2002. It's the largest study of its kind, say Duke University's David Kandzari, MD, and colleagues. It may help doctors decide whether to treat patients with balloon angioplasty or with much more invasive heart bypass surgery.
Stents are tiny wire tubes that prop open an artery after balloon angioplasty is used to clear a clog.
Out of some 12,000 patient records from 1990-2002, Kandzari and colleagues found 644 pairs of closely matched balloon angioplasty patients. One member of each patient pair received a stent during the balloon angioplasty; the other -- treated before the 1994 advent of stents -- didn't.
What happened? Patients who got stents had fewer repeat angioplasties. But after seven years of follow-up, those who got stents didn't survive any longer than those who did not get them.
"While stenting was associated with significant reduction in the need for [repeat procedures], it made absolutely no difference in long-term mortality," Kandzari tells WebMD. "In both groups there was about 20% mortality over seven years. This reminds us that stents, as used in the real world, are not associated with a survival advantage."
Kandzari presented the findings at this week's meeting of the American Heart Association in New Orleans.