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Posted by on Mar 5, 2018 in Coronary artery disease | 0 comments

In a nutshell

This study compared the safety and effectiveness of second generation drug eluting stents (DES) and bare-metal stents (BMS) in patients undergoing percutaneous coronary intervention (PCI). It was determined that second generation DES reduced the chances of experiencing a major adverse cardiac event (MACE). 

Some background

PCI (or angioplasty) is a non-surgical procedure where narrow or blocked arteries are widened or unblocked. In some cases a stent is implanted. A stent is a flexible tube that keeps the artery open. Drug-eluting stents (DES) also release medication into the body. These drugs prevent cells from gathering inside the stent and blocking it again. Bare-metal stents (BMS) do not release medications.

Second generation DES are believed to be safer than older DES. However, until recently, research about second generation DES has been limited.

Methods & findings

This study examined data from 9 other studies that compared second generation DES with BMS. 17,682 patients who underwent PCI participated in these studies. They were divided into two groups. One group received a second generation DES (9,089 patients), while the others received a BMS (8,593 patients). The participants were followed up for between 1 and 5 years, depending on the study.

The participants who received a second generation DES were 22% less likely to experience a MACE. A MACE may be a heart attack, death, or the need for revascularization. Revascularization means needing another PCI procedure, or a coronary artery bypass graft (a surgical procedure) in the same artery where the first PCI was done.

The participants who received a second generation DES were 33% less likely to have a heart attack than those who received a BMS. They were also 53% less likely to need revascularization. They were at least 43% less likely to form a blood clot inside the stent. However, survival rates were similar in both groups.

The bottom line

The study concluded that second generation DES reduced the likelihood of MACE, including heart attacks and revascularization. They also decreased the chances of clot formation inside the stent. However, no difference between second generation DES and BMS was found in terms of survival. 

The fine print

Different studies defined MACE differently, which may have made comparisons difficult.

What’s next?

Discuss the benefits of second generation DES with your physician.

Published By :

Clinical cardiology

Date :

Jan 25, 2018

Original Title :

Safety and efficacy of second-generation drug-eluting stents compared with bare-metal stents: An updated meta-analysis and regression of 9 randomized clinical trials.

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