Drug-Coated Stents May Not Be Riskier
Study: Risk of Heart Attack, Death Comparable 2 Years After Getting Drug-Coated Stents or Bare-Metal Stents
June 24, 2008 -- Drug-coated stents may not raise the risk of dying or having a heart attack compared to bare-metal stents, at least in some patients, a new study shows.
Stents are tiny metal mesh tubes that are inserted to hold open blocked or narrowed coronary arteries, which supply blood to heart muscle.
The first stents were bare metal. Newer stents were coated with drugs to help prevent the stents from clogging.
Some research has shown that drug-coated stents, also called drug-eluting stents, may be linked to higher risk of blood clots, heart attacks, and death.
But other research shows the opposite -- that drug-coated stents might be safer for some patients.
New Stent Study
The new stent study is based on data from about 67,000 Medicare patients.
The first group of patients got stents between October 2002 and March 2003, when only bare-metal stents were available. The second group of patients got stents from September through December 2003; 60% of patients got stents coated with a drug called sirolimus during this time.
None of the patients had recently had a heart attack, coronary artery bypass operation, or angioplasty. For all the patients in the study, this was their first stent.
The patients were followed for two years after their procedure.
During that time, the odds of death or heart attack were similarly low in both groups, but the odds of needing a coronary artery bypass or needing their stented coronary arteries reopened were lower for patients treated with drug-coated stents.
Whatever the risk of drug-coated stent-related clotting is, "it is more than offset" by the lower risk of needing a bypass or repeat angioplasty to reopen stented arteries, write Dartmouth Medical School's David Malenka, MD, and colleagues.
The results held for both sexes, for African-Americans and patients of other races, and regardless of age (although all patients were at least 65).
But because the study didn't include people younger than 65, people with a recent history of bypass surgery or angioplasty, people who got stents immediately after a heart attack, or people who got stents coated with drugs other than sirolimus, it's not clear if the findings also apply to them.
The study appears in The Journal of the American Medical Association. In the journal, Malenka and one of his colleagues note financial ties to various companies that make stents.