Coated Stents Best for Heart Patients With Diabetes
Nov. 11 -- MONDAY, Nov. 10 (HealthDay News) -- Drug-coated stents appear to be superior to bare metal stents in both efficacy and safety in patients with diabetes, new research shows.
"I would say consistently from randomized trials that there is clear efficacy and clear reduction for repeat revascularization procedures [with drug-coated stents]," said senior study author Dr. Laura Mauri, an assistant professor of medicine at Brigham and Women's Hospital and Harvard Medical School. "That is now also augmented by the fact that there is excellent safety in patients who have a similar ability to take dual antiplatelet therapy."
"That's an important caveat," Mauri added. "I think we have to judge our patients and get to know them as individuals and make determinations on a case-by-case basis. I wouldn't make a blanket statement, but, in general, there is great benefit to the use of drug-eluting stents in diabetic patients, and there does not seem to be a trade-off."
Mauri presented the findings Monday at the American Heart Association's (AHA) annual scientific sessions in New Orleans.
The safety of drug-coated stents versus conventional bare metal stents has been a matter of controversy for years.
Diabetics have a higher prevalence of ischemic heart disease than the general population, but percutaneous coronary intervention (PCI) has limitations in this group, including a higher rate of restenosis and subsequent heart attack and death.
"There is controversy regarding selecting PCI as a treatment for patients with diabetes," said Dr. David Williams, with Brown University and Rhode Island Hospital in Providence. "One of the major shortcomings of PCI in this patient subset has been a relatively high need to perform repeat revascularization. Drug-eluting stents may offer a potential advantage in that regard, but there is some concern as to whether they are as safe as bare metal stents."
Mauri presented three-year follow-up data for a subgroup of about 5,000 diabetic patients undergoing PCI with stenting to reopen blocked vessels.
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