In a nutshell
This study examined the long term safety of bare metal and drug-eluting stents.
Some background
Stents are meshed wire tubes that are placed in blood vessels to open them up. There are two types of stents – bare-metal stents and drug-eluting stents. Bare-metal stents are made of a metal mesh. Drug–eluting stents slowly and continuously release medication to prevent blood vessels from becoming blocked again. These medications include paclitaxel (Taxol) and sirolimus (Rapamune).
Newer drug–eluting stents have been developed. Medications used in these newer stents include everolimus (Afinitor), biolius (umirolimus), and zotarolimus. Initial studies suggested that these new stents are safer to use than the older drug-eluting stents and bare-metal stents. However, the long-term safety of these newer stents is not known.
Methods & findings
The authors looked at various trials that studied safety of FDA–approved stents. 51 trials with 52,158 patients were analyzed. Patients were followed for an average of 3.8 years.
Patients with cobalt-chromium everolimus–eluting stents were less likely to have stent thrombosis (when a previously placed stent becomes blocked by a blood clot) than patients with bare-metal stents, paclitaxel-eluting stents and sirolimus-eluting stents.
Patients with biolimus-eluting stents were 44% less likely to have stent thrombosis than patients with bare-metal stents. They were also 47% less likely to have stent thrombosis than patients with paclitaxel–eluting stents, and 42% less likely than patients with sirolimus-eluting stents.
Cobalt-chromium everolimus–eluting stents were associated with slightly lower rates of death and lower rates of heart attack than sirolimus-eluting stents, paclitaxel-eluting stents or bare-metal stents.
Zotarolimus–eluting stents and sirolimus-eluting stents were associated with lower rates of heart attack than paclitaxel-eluting stents. All drug-eluting stents were associated with lower rates of revascularisation (having to restore blood flow to the blood vessel again) than bare-metal stents.
The bottom line
The authors concluded that drug-eluting stents were safer than bare-metal stents. The newer drug-eluting stents had improved long-term safety than the older drug-eluting stents.
What’s next?
Talk to your doctor about the different types of drug-eluting stents available.
Published By :
Journal of the American College of Cardiology
Date :
Jun 16, 2015
