Which Type of Stent is Best for Heart Patients?
Reported October 04, 2007
(Ivanhoe Newswire) — More research on drug-eluting stents shows theyre still the better choice for many patients with heart disease.
People undergoing percutaneous coronary intervention, or PCI, to open up clogged arteries often receive stents to help keep those arteries open over the long haul. Doctors have two types of stents to choose from: bare-metal or drug-eluting, but safety concerns regarding the latter have called their use into question.
Specifically, some studies suggest drug-eluding stents, which are coated with medications to help keep the blood flowing smoothly, may raise the risk of blood clots and heart attacks.
Canadian researchers say theres good reason to choose drug-eluting stents for people with two or more risk factors for restenosis, or re-clogging of the arteries. They compared more than 3,700 pairs of patients who had bare-metal stents or drug-eluding stents. Results show the drug-eluting stents were better at reducing the need for another procedure to open the arteries in people with these risk factors.
Overall, about 7 percent of people receiving the drug-eluting stents needed another procedure within 2 years, compared to nearly 11 percent of those who received bare-metal stents. Most of the difference was attributed to high-risk individuals. The mortality rate was actually lower in the drug-eluting stent group, about 5 percent over three years versus nearly 8 percent in the bare-metal stent group. Heart attack rates were similar between the two groups.
The authors conclude drug-eluting stents may be the best choice for people at high risk for another PCI procedure to re-open the arteries. They call for more study to investigate their finding on reduced mortality for patients receiving the drug-eluting stents.
SOURCE: The New England Journal of Medicine, 2007;357:1393-1402
