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Drug-eluting stents cut mortality in "real-world" setting
Monday, 29 November 1999 19:00 | 
| Radiology News - Radiology Articles |
Randomized trials have shown a survival benefit to using drug-eluting stents (DES) rather than bare-metal stents (BMS) in heart disease patients. Now, the results of a single-center observational study suggest that this survival benefit also extends to the "real-world" setting.
In recent years, use of DES has fallen off, primarily over concerns of late stent thrombosis and increased mortality, particularly in patients with serious comorbidities and in those who don't comply with antiplatelet therapy regimens. Nonetheless, recent data suggest that these stents are, in fact, safe and may actually prevent MI and death.
In the current study, reported in the Journal of the American College of Cardiology for September 23rd, Dr. Stephen G. Ellis and colleagues at the Cleveland Clinic compared the outcomes of 6053 patients who received a DES and 1983 given a BMS from March 2003 through June 2007.
During 4.5 years of follow-up, 832 patients died, the report indicates.
In the overall, adjusted analysis, DES use reduced mortality by 38 per cent relative to BMS use (p < 0.001), the report indicates. On the propensity-matched analysis, which sought to compare similar patients in each group, DES use was tied to a 46 per cent reduction in risk (p < 0.001).
"In patients undergoing percutaneous coronary intervention with DES or BMS in the 'real-world' setting, the use of DES appears to be associated with lower all-cause mortality," the Cleveland researchers conclude. "This result was persistent despite multiple adjustments, including propensity analysis, stratified analysis by procedure year, and by subgroup analysis."
"Additionally," they note, "adjustment for socioeconomic status, presence of cancer, anemia, or renal insufficiency did not change this result."
J Am Coll Cardiol 2008;52:1041-1048
