A new study by researchers at Rhode Island Hospital has found that Drug-eluting stents are as safe and effective as traditional bare-metal stents when used in routine clinical practice. These findings are published in the November 20th issue of the Journal of the American College of Cardiology.
Drug-eluting stents or medication-coated stents are tiny tubes used to open narrowed arteries and slowly release a drug to prevent scar tissue growth. Accepted worldwide, they are considered more superior than more traditional, bare-metal stents. Despite the limited availability of data comparing the generalized use of both stents, the drug -eluting stents have an edge over their traditional counterparts.
"Considering that drug-eluting stents are being used in the vast majority of stent procedures, its reassuring to find that they yield better outcomes than bare-metal stents when used in routine clinical practice," said lead researcher J. Dawn Abbott, M.D., a cardiologist at Rhode Island Hospital, also an assistant professor of medicine at The Warren Alpert Medical School of Brown University.
Broad geographic data from the National Heart, Lung and Blood Institute (NHLBI) Dynamic Registry was used by Abbott and her team who compared outcomes for patients who underwent percutaneous coronary intervention - or angioplasty - and were treated with stents. One such group received drug-eluting stents while another received bare-metal stents when they were used more broadly before the commercialization of drug-eluting stents. Though separated by a few years time, no other technologic advances other than drug-eluting stents occurred between recruitment of both groups of patients.
The study also revealed that for a period of one-year drug-eluting stents in standard clinical practice patients treated with drug-eluting stents did not involve any excess risk of death or heart attack as compared to bare-metal stents even in patients with severe heart lesions. The cumulative death and heart attack rate in patients receiving drug-eluting stents was 7.6 percent to that of 8.7 percent in those treated with bare-metal stents.
In patients treated with drug-eluting stents also there was a substantial reduction in clinically-driven target vessel revascularization (repeat angioplasty or bypass surgery of the target vessel) compared with patients who received bare-metal stents (5 percent vs. 8.7 percent). Moreover drug-eluting stents also resulted in enhanced durability of the initial angioplasty.
"These findings confirm the safety and effectiveness of drug-eluting stents out to one year, but we are continuing to follow these patients to assess for possible late complications related to the stent implantation," said senior author David O. Williams, M.D., a cardiologist at Rhode Island Hospital and a professor of medicine at Alpert Medical School.
This analysis compared 1,460 patients enrolled in the NHLBI Dynamic Registry in 2004 who received at least one drug-eluting stent and 1,760 patients who enrolled just before the approval of drug-eluting stents (2001 to 2002) and received at least one bare-metal stent.
They looked at lesion characteristics and procedural outcomes and both in-hospital and clinical outcomes after one year. All patients had also undergone angioplasty at selected clinical centers in North America. The study included drug-eluting stents that released either sirolimus or paclitaxel.