Unless you, or a family member, have suffered a heart attack or severe heart condition, it’s a good bet that you don’t know your metal stent from a drug-coated stent. Stents are small, lattice-shaped, metal tubes frequently used to treat blockages in the blood vessels of the heart. Once in place, stents help hold the arteries open so that the heart muscle gets enough blood. Stents can be made of only metal (bare-metal stents) or they can be coated with small amounts of drugs that are released over time to help keep the arteries from being blocked again (drug-eluting stents). Both types of stents are considered to be safe and effective when used according to their instructions, but a new study has found the drug-eluting stents to be more beneficial for people who have heart attacks.

In the largest study to date comparing the two medical devices, researchers from Harvard Medical School and Brigham and Women’s Hospital followed 7,217 heart attack victims in Massachusetts who were given stents in 2003 and 2004. Each drug-eluting stent patient was matched with a bare-metal stent patient and followed for two years. During this time, 8.5 percent of the 4,016 patients who received the drug-eluting stents died, compared to 11.6 percent of the 3,201 bare-metal stent recipients. The incidence of second heart attack was also lower in the drug-eluting stent group; 7.4 percent compared to 8.5 percent of those getting bare-metal stents. In addition, only 10.7 percent of the drug-eluting stent patients required a repeat procedure, compared to 14.9 percent of those receiving bare-metal stents. “We conducted this study to understand whether drug-eluting stents are safe in this situation. It is very reassuring that drug-eluting stents were actually associated with better survival and fewer repeat procedures,” said study author Dr. Laura Mauri, an assistant professor of medicine at Harvard Medical School and an interventional cardiologist at Brigham and Women’s Hospital.

The lower rate of repeat procedures probably contributes to the higher survival rate, as do the anti-clotting medications, explained Dr. Mauri. While not all patients may be able to tolerate those drugs, as many as 80 percent of heart attack victims could benefit from the drug-eluting devices, she said.

Some studies have cast doubt on whether drug-eluting stents are better than bare-metal stents. One study in particular, released late last year by Danish researchers, linked drug-eluting stents to the development of potentially fatal blood clots. “There were concerns about the long-term safety of these stents compared with bare-metal stents,” said study author Dr. Laura Mauri, an assistant professor of medicine at Harvard Medical School and an interventional cardiologist at Brigham and Women’s Hospital. “We were looking to see if there was a risk, and we actually saw there was a benefit.”

According to the U.S. National Institutes of Health, of the 1 million stents implanted in U.S. patients annually, about half are used for heart attack victims. One important reason why a bare-metal stent is implanted after a heart attack is fear that the patient might not follow advice to take the clot-preventing drug clopidogrel. “Patients present emergently and there’s less time for the physician to be able to really go through a discussion of ability to take those medications and ability to comply with the therapy long term,” Dr. Mauri said. “If they can’t take clopidogrel long-term, there may be a higher risk of thrombosis.”

The study researchers conclude that, while the drug-eluting stents work better on average, the choice of stent still requires careful consideration of each individual patient’s condition.

The study findings are reported in the September 25 issue of the New England Journal of Medicine and are expected to be released at the American Heart Association meeting in November.

Medical Updates – Drug-Coated Stents Beneficial for Heart Attack Victims | Health News