Drug-Coated Stents Don’t Improve Patient Survival
By E.J. Mundell
WEDNESDAY, Aug. 31, 2016 (HealthDay News) — The largest trial ever conducted on stents — tiny tubes that help keep heart arteries open — suggests that pricey drug-coated (or eluting) versions may perform no better for patients over the long-term, in terms of patient survival, compared to cheaper, “bare metal” versions.
“The evidence in favor of contemporary drug-eluting stents over bare-metal stents may not be as strong as has been thought,” said study author Dr. Kaare Harald Bonaa. He’s from the Norwegian University of Science and Technology in Trondheim, Norway.
Bare-metal stents were used in the early days of stenting. But, arteries sometimes re-closed around the stent. That meant surgeons often had to go back in and re-open the vessel — a procedure called revascularization.
Then came drug-eluting stents. These devices were coated with drugs to prevent the vessel re-closure that plagued so many patients. These newer stents quickly became popular with doctors, but at prices that were often thousands of dollars more than bare-metal versions, according to previous research.
The new study sought to revisit the issue of bare-metal versus drug-eluting stents, and is the largest of its kind to date, Bonaa said. His team tracked six-year outcomes for more than 9,000 patients. Patients received a stent after suffering recurrent chest pain (angina) or an event such as a heart attack.
Patients who received a drug-eluting stent typically received devices coated with anti-clotting drugs that are still in frequent use today, Bonaa said.
Patients who received a drug-eluting stent did, as expected, have less need for a second revascularization procedure, but not to the level surgeons might have expected, Bonaa said.
In fact, “thirty patients would need to be treated with drug-eluting stents rather than with bare-metal stents to prevent one repeat revascularization,” he said.
Overall rates of revascularization procedures were low in each group, he noted: 16.5 percent in the drug-eluting stent group versus 20 percent in the bare-metal stent group.