Drug-eluting stents safer than metallic ones in preventing cardiac deaths

Washington, March 29 (IANS) Drug-eluting stents (DES) were found to be safer and superior than bare metal stents in preventing death and heart attacks among 262,700 patients enrolled in a nationwide registry of cardiovascular disease.

These results have been validated by the largest study of its kind, conducted by the Duke University Medical Centre (DUMC), which may end years of controversy over the safety of the devices.

Stents are small tubes that can prop open blocked coronary arteries. The earliest versions were made of bare metal mesh, but later models were designed to release a medication that could suppress the growth of restenosis, new tissue that could clog up the arteries again.

After initially proving more effective than bare metal stents (BMS) in preventing restenosis, DES suffered a setback when recent clinical trials found them associated with higher long-term death rates.

'We hope these findings will finally lay to rest any doubt about the safety of drug-eluting stents,' said Pamela Douglas, cardiologist and member of the Heart Centre at DUMC and the study's lead author. 'Our results clearly show that drug-eluting stents are indeed safe.'

Douglas and colleagues followed patients over age 65 enrolled in the National Cardiovascular Data Registry who received stents from 2004 to 2006.

Most of the patients received a DES; only 17 percent were implanted with BMS variety. Investigators matched the patients' data with their Medicare claims and followed them for two-and-a-half years, measuring rates of death, heart attack, stroke, bleeding and the need for additional artery-opening procedures.

They found that over the 30-month period, patients in the DES group had a 25 percent reduction in death and 24 percent reduction in heart attacks, when compared with those who received BMS, but no significant difference in the incidence of stroke, major bleeding or need for additional artery-opening procedures, said a DUMC release.

The findings appear online in the Journal of the American College of Cardiology.