Stents keep coronary vessels free
The mortality risks associated with drug-eluting and bare-metal stents for the heart are similar. Following the recent debate about increased risk of death and stent thrombosis associated with drug-eluting as compared with bare-metal stents researchers at the University of Bern, Switzerland did a meta-analysis, which included 38 trials and data from 18023 patients, with a follow-up period of up to four years. Trialists and stent manufacturers also provided additional data on clinical outcomes for 29 trials.
The researchers found that mortality was similar in the three groups. However siromilus-eluting stents were found to give a reduced-heart attack risk of 19% versus bare-metal stents and 17% versus paclitaxel-eluting stents. And while there were no significant differences in the risk of definite stent thrombosis, the risk of late definite stent thrombosis - occurring more than 30 days after implantation - was more than twice as high for paclitaxel-eluting stents versus bare-metal stents, and 85% higher for paclitaxel-eluting stents versus siromilus-eluting stents.
The authors found no evidence for an increase in the risk of late stent thrombosis for sirolimus-eluting as compared with bare-metal stents.
Both drug-eluting stents reduced the risk of target-lesion revascularisation compared with bare-metal stents: siromilus-eluting stents by 70%, and paclitaxel-eluting stents by 58%. Compared with paclitaxel-eluting stents, siromilus-eluting stents reduced this risk by 30%.
The researchers say: "We conclude, therefore, that siromuilus-eluting stents seem to be clinically better than bare-metal and paclitaxel eluting-stents."
COMPAMED.de; Source: The Lancet