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Paclitaxel Stent Is Treatment Option for Patients Over 70

Stent found to have lower revascularization rate than bare metal stent in pooled data analysis

WEDNESDAY, June 3 (HealthDay News) -- The paclitaxel-eluding stent (PES) can be used effectively in people over 70, according to an analysis of trial and registry data on almost 10,000 PES patients reported online June 2 in Circulation: Cardiovascular Interventions.

Daniel E. Forman, M.D., of Brigham and Women's Hospital in Boston, and colleagues pooled and analyzed the patient data from five randomized trials (2,271 PES patients, 1,397 bare metal stent [BMS] patients) and from two registries (7,492 PES patients) to assess the benefits of the device for older patients. The analysis stratified patients by age (under 60, 60 to 70, and over 70) and included PES comparisons to BMS.

At baseline, the researchers found that the patients over 70 had more adverse characteristics and comorbid conditions than the younger patients, such as chronic heart failure, prior bypass surgery, and high blood pressure. Analysis found that patients over 70 had a comparable rate of heart attack, stent thrombosis, and target lesion revascularization to younger patients. While the death rate for patients over 70 was higher than the younger patients, it was comparable to general population norms matched for age and gender. Compared to BMS patients, the PES patients over 70 had a significantly lower target lesion revascularization rate (22.2 versus 10.2 percent).

"This analysis of almost 10,000 cumulative patients who received PES demonstrated that age greater than 70 years had significantly more comorbid conditions and baseline risk factors, yet had comparable short- and long-term stent-related outcomes to younger patients," the authors conclude.

The study was supported by Boston Scientific. Several of the authors reported financial relationships with device making companies, including Boston Scientific.

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