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Drug-Eluting Stents Stack Up Well Against Bare-Metal Stents

Last Updated: May 01, 2009.

The use of drug-eluting stents appears safe and efficacious compared to bare-metal stents in patients with ST-segment elevation myocardial infarction, according to research published in the May 5 issue of the Journal of the American College of Cardiology.

FRIDAY, May 1 (HealthDay News) -- The use of drug-eluting stents (DES) appears safe and efficacious compared to bare-metal stents (BMS) in patients with ST-segment elevation myocardial infarction (STEMI), according to research published in the May 5 issue of the Journal of the American College of Cardiology.

Somjot S. Brar, M.D., of the Columbia University Medical Center in New York City, and colleagues conducted a systematic review and meta-analysis of 13 randomized controlled trials, including 7,352 patients with STEMI who were randomly assigned to receive DES or BMS.

DES were associated with a lower risk of target vessel revascularization (relative risk, 0.44), the investigators found. However, the risk of death, myocardial infarction and stent thrombosis was not significantly different between the groups, and these findings endured for two years. In addition, among 18 registries including 26,521 patients, DES were also associated with less target vessel revascularization (relative risk, 0.54), but with no differences in deaths within two years of the index percutaneous coronary intervention, the report indicates.

"The benefit of DES against restenosis should be balanced against the risk of adverse events, stent thrombosis in particular. Stent thrombosis remains a serious complication, associated with increased morbidity and mortality. The use of DES in STEMI has been identified as a predictor of stent thrombosis in some observational studies. However, in the present analysis, stent thrombosis does not appear to differ between DES and BMS," the authors write.

Several co-authors disclosed relationships with companies including Boston Scientific, Abbott, Medtronic, and Cordis.

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