Drug-Coated Stents Better at Keeping Arteries Open
May 7 -- WEDNESDAY, May 6 (HealthDay News) -- Although arteries propped open by drug-coated stents are less likely to become blocked again than those treated with bare-metal stents, the risk of death and heart attacks is virtually identical between the two devices, major studies in Sweden and the United States show.
The Swedish results eliminate concerns raised by an earlier study that the drug-coated stents might actually be more dangerous, said Dr. Stefan K. James, an associate professor of cardiology at Uppsala University and lead author of the Swedish study appearing in the May 7 issue of the New England Journal of Medicine.
The earlier study, of Swedes given stents in 2003 and 2004, found a higher death rate among those who got the drug-coated kind. The follow-up study of 47,967 Swedes who had stents implanted between 2003 and 2006 found "no overall difference between the group that received drug-eluting stents and the group that received bare-metal stents in the combined endpoint of death or myocardial infarction [heart attack]," the report said.
But the rate of re-stenosis -- new blockage of the treated artery -- was three per 100 patient years versus 4.7 for the bare-metal recipients.
So the earlier result was "just a scary signal" that proved to be false, James said.
"For me, this paper shows that there should now be no real concerns about the safety of drug-eluting stents and that the emphasis should shift back to considering the relative efficacy of drug-eluting stents and bare-metal stents," Dr. Eric Eeckhout, a spokesman for the European College of Cardiology, said in a statement.
James's interpretation of the study is that use of drug-coated stents should be limited to cases where the risk of re-stenosis is high -- when the blockages are in smaller blood vessels and are long in length and when the person has diabetes, for example.
Cost plays a role in his judgment, James said. "The prices of drug-coated stents have gone down in Europe, but they cost twice as much here [in Europe] as the bare-metal stents," he said.
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