Outcomes of Drug-Eluting Versus Bare-Metal Stent Analyzed

Drug-eluting stent era associated with a decreased incidence of repeat revascularization

TUESDAY, June 24 (HealthDay News) -- The widespread use of drug-eluting stents has decreased the incidence of repeat revascularization but has not increased the risk of death or ST-elevation myocardial infarction compared to the use of bare-metal stents, according to a report published in the June 25 issue of the Journal of the American Medical Association.

David J. Malenka, M.D., of the Dartmouth-Hitchcock Medical Center in Lebanon, N.H., and colleagues compared outcomes in 38,917 Medicare patients who underwent non-emergent bare-metal stenting between October 2002 and March 2003, and 28,086 patients who underwent non-emergent stenting (61.5 percent with a drug-eluting stent) between September and December 2003.

Compared to patients in the bare-metal stent era, the researchers found that patients in the drug-eluting stent era had lower two-year risks for repeat percutaneous coronary interventions (17.1 percent versus 20 percent) and coronary artery bypass surgery (2.7 percent versus 4.2 percent). They also found that there was a similar adjusted hazard of death or ST-elevation myocardial infarction at two years (hazard ratio, 0.96).

"Although other data may suggest some incremental risk of stent thrombosis with the use of drug-eluting stents, we can detect no adverse consequence to the health of the population," the authors conclude. "We speculate that whatever the increased risk of stent thrombosis associated with drug-eluting stent use is, it is more than offset by a decrease in the risk of developing restenosis and the attendant risk of a procedure to treat that restenosis."

Two of the study authors report research funding from medical device companies including Guidant Endovascular Systems and Abbott Vascular. One is also a principal of Tryton Medical Inc., a venture company focused on stent technology.

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