A network meta-analysis of 38 randomised controlled trials involving over 18,000 patients suggests that the mortality risks associated with drug-eluting stents and bare-metal stents are similarly low.
Funded by Swiss National Science Foundation, the network meta-analysis was designed to compare the safety and effectiveness of bare-metal stents, drug-eluting stents (Cypher Stent) and the Taxus Stent in a large patient population to increase the ability to detect and understand low frequency events, such as death and stent thrombosis.
The analysis found a substantial reduction in the risk of myocardial infraction (heart attack) and reintervention with drug-eluting stent (Cypher Stent), when compared to bare-metal stents and the Taxus stent.
The findings also included a significant reduction in the risk of blood clots occurring more than 30 days after stent implantation with the drug-eluting stent, compared to the Taxus stent.
"This large set of data indicates that the mortality associated with drug-eluting stents and bare-metal stents is comparable. Recent concerns about increases in mortality associated with drug-eluting stents are not supported by this analysis assessing long-term outcomes," stated Dr Christoph Stettler from the University of Bern, Switzerland, one of the authors of the study.
"These results have also led us to conclude that the Cypher Stent is clinically superior to bare-metal stents and the Taxus Stent when the safety and effectiveness outcomes in this analysis are taken into account," added corresponding author Dr. Peter Juni, Head of Division, Clinical Epidemiology and Biostatistics, University of Bern.
Published in the journal Lancet, the network meta-analysis was the largest of its kind to date comparing drug-eluting stents to bare-metal stents.
"This network meta-analysis constitutes the largest and most robust set of data published to date in an eminent international peer-reviewed journal assessing the long-term safety and efficacy outcomes of drug-eluting stents," said Dr. David E. Kandzari, Chief Medical Officer, Cordis Corporation.
"It significantly enriches the large body of evidence that interventional cardiologists have at their disposal to make the right choice for their patients. These data clearly demonstrate the benefits of drug-eluting stents versus bare metal stents and further provide clarity as to the differences between the Cypher Stent and the Taxus Stent," he added.