Expensive drug-coated stents may hold no long-term benefits over traditional bare-metal versions of the device, according to a study published Tuesday in the New England Journal of Medicine.
Drug-coated stents were developed after physicians found the arteries of patients implanted with bare-metal stents often closed up again, requiring a second revascularization procedure to fix the blocked artery. Newer drug-eluting stents are coated with anti-clotting drugs to prevent the artery from closing up and cost substantially more than bare-metal stents.
Norwegian researchers tracked the six-year outcomes of more than 9,000 patients who received a stent after suffering from recurring chest pain or cardiac events like a heart attack. They found no significant difference between the two types of stents in terms of patient deaths, nonfatal heart attacks, angina and patient quality of life.
As expected, patients with drug coated stents did have less need for a second revascularization procedure, but not at a rate surgeons would expect, said Kaare Harald Bonaa, MD, PhD, lead author of the study. About 16.5 percent of patients with drug-coated stents needed a second procedure, compared to 20 percent of patients in the bare-metal stent group.
"Thirty patients would need to be treated with drug-eluting stents rather than with bare-metal stents to prevent one repeat revascularization," Dr. Bonaa said. "The take home message is that patients treated with drug-eluting stents do not live longer or better than patients treated with bare-metal stents."
Researchers said they have not determined how the findings may change current practices, according to the report.
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