Drug-Coated Stents: High Marks for Safety
Studies Show Drug-Coated Stents Have Lower Risk of Renarrowing of Arteries Than Bare-Metal Stents
Death Rates for Stents continued...
"We found warning signs of an increase in mortality among patients treated with the drug-eluting stents in patients followed for up to three years," James tells WebMD.
In their latest analysis, the researchers followed patients for up to five years and found little difference in mortality among those treated with drug-coated and non-drug-coated stents.
Swedish patients who were among the first to get the drug-coated stents did have higher death rates than patients treated with bare-metal stents, and James thinks he knows why.
"I think we were overly optimistic when we started using drug-eluting stents," he says. "We thought that everything could be solved with them and we started stenting very sick patients."
These days, patients are more carefully selected, and drug-coated stents are used only in those who are able to take blood-thinning drugs to reduce the risk of clotting.
Patients in the Swedish study who got the drug-coated stents were less likely to have their treated vessel reclog. This was especially true among high-risk patients, including those with diabetes, small vessels, and long or complicated blockages, James says.
Stents and Renarrowing of Arteries
In the U.S., roughly three out of four stent-treated patients receive the drug-coated devices, Gregg W. Stone, MD, of Columbia University tells WebMD.
In their newly reported trial, Stone and colleagues followed 3,006 patients treated with stents during a heart attack for a year.
Three-fourths of the patients received stents treated with the drug paclitaxel and the rest got bare-metal stents. The study was funded, in part, by drugmaker Boston Scientific, which makes the drug-coated stent used in the study.
The analysis revealed that:
- Restinosis leading to recurrent chest pain, hospitalization, and repeat artery-opening procedures was reduced by 41% in the drug-coated stent group.
- Renarrowing of the treated artery, as measured by an angiogram, was reduced by 56% in patients treated with the drug-coated stents.
- Rates of death, second heart attack, and stroke were not significantly different between the two groups.
Stone says angioplasty, bare-metal stents, and drug-coated stents are equally effective for saving lives during a heart attack.