In a nutshell
The aim of this study was to compare the safety and effectiveness of 3 different drug-releasing stents for the heart blood vessels (biodegradable stents versus new permanent stents versus older permanent stents) after 10 years. The main finding of the study was that biodegradable and new permanent stents showed similar results and were better than older permanent stents.
Some background
Coronary artery disease (CAD) means that the blood vessels to the heart become blocked. Placing stents in the blood vessels of the heart is an important part of the management of CAD. Stents are small tubes that keep the blood vessels open. This allows blood to flow to the heart muscle.
Nowadays, drug-releasing stents are normally used. These slowly release a drug over time to prevent the blood vessel from becoming blocked again. These stents can be made of different materials. They can be biodegradable (BIO), which means it will be fully absorbed over time. Alternatively, they can be permanent. There are older (OLD-P) and newer (NEW-P) models of permanent stents.
It is unknown which of these stents has the best long-term outcome.
Methods & findings
This study included 2603 patients who were randomized to receive either a BIO, OLD-P or NEW-P stent. Major adverse cardiac events (MACE) of each group were analyzed after 10 years. MACEs include death, heart attack or further required procedures on the stent.
After 10 years, the rate of MACE in each group was 47.7% with BIO, 46% with NEW-P and 54.9% with OLD-P. The rates of death were BIO 31.8%, NEW-P 30.3% and OLD-P 37.2%. The rates of definite blood clots into the stent were BIO 1.1%, NEW-P 0.8% and OLD-P 2.4%.
The bottom line
The authors concluded that BIO and NEW-P had similar outcomes after 10-years. However, OLD-P had higher rates of MACE and stent clots.
The fine print
The causes of death in these patients may not have been related to their heart health.
Published By :
Circulation
Date :
Jan 15, 2019
