Heart Attack? Drug-Coated Stents Best

Study Vanquishes Worry That Drug-Coated Stents Increase Heart Attack Deaths

Medically Reviewed by Elizabeth Klodas, MD, FACC on September 24, 2008
From the WebMD Archives

Sept. 25, 2008 - Drug-coated stents are safe for all heart attack patients, a large study shows.

The 7,217-patient study was designed to address worries that using newer drug-coated stents instead of older bare-metal stents increases the risk of death for some heart attack patients.

Not only did the drug-coated stents turn out to be safe, they turned out to be safer. No matter what kind of heart attack a patient had, the two-year risk of death was somewhat less if drug-coated stents were used."We observed small absolute differences in mortality that favored drug-[coated] stents," report Brigham and Women's researcher Laura Mauri, MD, and colleagues. "These observations were consistent for all [heart attacks] and for both subtypes of [heart attack]."

Stents are thin mesh tubes used to prop open clogged arteries. Drug-coated stents -- doctors call them drug-eluting stents -- give off a medication that helps keep the artery from reclogging.

However, the drug increases the risk that a deadly blood clot will form, so patients have to stay on blood-thinning drugs for a year after getting a drug-coated stent.

A recent study suggested that patients with a kind of heart attack with a specific electrocardiogram signature -- ST-segment elevation -- have twice the risk of dying if they get a drug-coated stent instead of a bare-metal stent.

Mauri and colleagues looked at two-year outcomes for heart attack patients who got drug-coated stents (4,016 patients) or bare-metal stents (3,201 patients). There were patients in both groups with and without ST-segment elevation.

The findings:

  • Overall, the two-year risk of death was 10.7% with drug-coated stents and 12.8% with bare-metal stents.
  • For patients with ST-segment elevation, the two-year risk of death was 8.5% with drug-coated stents and 11.6% with bare-metal stents.
  • For patients without ST-segment elevation, the two-year risk of death was 12.8% with drug-coated stents and 15.6% with bare-metal stents.

Mauri and colleagues note that their look-back study was designed to see whether drug-coated stents were safe. Only a look-ahead clinical trial can prove whether one stent really saves more lives than another.

The study findings appear in the Sept. 25 issue of The New England Journal of Medicine.

Show Sources


Mauri, L. The New England Journal of Medicine, Sept. 25, 2008; vol 359: pp 1330-1342.

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