Monday, March 30, 2009

Late-breaking clinical trial at ACC: Long term outcomes related to stents
By Kelly Winget, DCRI Communications

For patients that have blocked arteries that need to be widened to improve blood flow, cardiologists will typically perform angioplasty and insert stents to keep the arteries open. The stents can either be bare metal or coated with drugs to help prevent clots from reforming.

Clinical trials have offered some contradictory information about the benefits of drug eluting stents (DES) versus bare metal stents (BMS). For example, trials have found that patients who receive DES have fewer incidences of their arteries re-narrowing. But other trials have reported higher rates of blood clots at the stent site or higher risks of death in patients who received DES.

The DCRI's Pamela Douglas, MD, led a new study to examine the long term effectiveness and safety of DES compared to BMS in a real-world setting. The results were presented Saturday, March 28 as a late-breaking clinical trial session at the American College of Cardiology Annual Scientific Session .

The study reviewed data on all patients 65 years or older who were included in the National Cardiovascular Data Registry and who had stents inserted between 2004 and 2006. Researchers reviewed data on more than 262,000 patients at 650 sites. Of the patients, 83 percent received DES and were divided roughly in half between the two different types of drugs than are used to coat stents.

Researchers looked at patient outcomes at 30 months following when a stent was inserted.

After adjustments, researchers found no identifiable safety concerns for patients who received a DES. The patients who did have a DES implanted had lower risks of death and lower risks of having a heart attack. They also had slightly lower risks of major bleeding, and had the same risk of having a stroke as patients who received a BMS.

Other DCRI researchers involved with the study include Matthew Brennan, MD, Kevin Anstrom, Phd, Eric Eisenstein, DBA, David Kong, MD, and senior author Eric Peterson, MD.