Drug eluting stents provide better outcomes that bare metal stents in angioplasty

Two newspapers recently published an opinion piece and an editorial on the qualifications of Sanjay Gupta, a neurosurgeon and chief medical correspondent at CNN, whom President-elect Barack Obama reportedly seeks to nominate as the next U.S. surgeon general. Summaries appear below. Peter Canellos, Boston Globe: Gupta has “fine” credentials “for a young doctor, but

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Patients receiving drug eluting stents (DES) - stents coated with medication to prevent narrowing of the artery - as part of an angioplasty had better outcomes one year later than patients with bare metal stents, according to a new study to be published in CMAJ.

Mortality in the first 30 days for people with drug eluting stents was significantly lower than for those with bare metal stents. However, in this prospective cohort study of 6440 patients, there was an increased risk of repeat revascularization procedures or death in the DES group after 3 years.

Patients with drug eluting stents were more likely to be female, with higher rates of kidney disease, diabetes, high cholesterol and hypertension.

“Our study findings suggest that drug eluting stents, despite recent concerns surrounding drug eluting stent safety, the long-term survival (to 3 years) of patients receiving drug eluting stents remains globally favourable, and certainly not measurably worse than that of patients treated with bare metal stents,” state Dr. William Ghali, coauthors from the University of Calgary and Dr. Andrew Philpott. “However, we did observe a concerning risk trend toward accelerating adverse events in the DES group late in the follow-up period - a finding that underlines the need for ongoing surveillance of longer-term outcomes,” write the authors.

Visit cmaj.ca later this week for a related commentary by Dr. Philippe Généreux and Dr. Roxana Mehran from the Columbia University Medical Center. They also caution that “despite the large amount of favourable long-term data on the use of drug eluting stents from randomized controlled trials, meta-analyses and observational studies, the long-term safety of drug eluting stents, especially regarding late and very late stent thrombosis, remains a major concern.”



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Drug-eluting stents reduced the risk of revascularization, heart attack and death in diabetics as compared with bare-metal stents in the largest observational comparison, researchers reported at the American Heart Association’s Scientific Sessions 2008. The results from The Drug-eluting and Bare Metal Stenting in Patients with Diabetes Mellitus: Results from the Mass-DAC Registry, were presented

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The naturally high levels of leptin in diabetic patients may reduce the effectiveness of drug-eluting stents used to treat heart blockages, but using a chemical that differs from the one commonly used to coat stents could counteract this effect. The work by researchers at Columbia University Medical Center could potentially improve outcomes in diabetics who

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A nanomatrix for stent coating designed at the University of Alabama at Birmingham (UAB) mimics natural endothelium, the substance that lines blood vessels, and promises the potential to prevent post-operative tissue scaring along the blood vessel wall, greatly reducing the possibility of future thrombosis, or blockage at the stent site. This next generation nanotechnology could

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Invatec, a comprehensive innovator of interventional products, today announced the European launch of a new peripheral balloon, the IN.PACT Amphirion paclitaxel-eluting PTA balloon catheter. This is the first drug-eluting catheter designed specifically to treat atherosclerosis in arteries located below the knee (BtK). IN.PACT features FreePac, a proprietary coating that frees and separates paclitaxel molecules and

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