Drug Stent Safety Fears Ease
Fewer drug-coated stents are being inserted into the arteries of Australian heart disease patients following concerns about their long-term safety, even though new evidence shows that these stents are safe, according to research published in the latest issue of The Medical Journal of Australia (MJA).
Associate Professor Andrew Ajani, Director of the Coronary Care Unit at the Royal Melbourne Hospital, and colleagues analysed outcomes for more than 6,000 patients receiving coronary stents over a 3-year period.
Stents are tiny tubes placed into narrowed, diseased coronary arteries to hold them open. Drug-eluting stents (DESs) are coated with a drug that helps prevent the vessel from re-narrowing.
Following concerns raised in the USA about a potential increased risk of thrombosis, heart attack or death one month to several years after DES implantation, the use of DESs has begun to decline.
However, Assoc Prof Ajani and colleagues found no increased risk associated with the use of DESs compared with bare-metal stents (BMSs) in the first year after deployment.
"Our 12-month mortality rates were lower in patients receiving DESs than those receiving BMSs," he said.
"While most DES studies have reported a high level of stent safety, emerging evidence of late and very late stent thrombosis, myocardial infarction and mortality has challenged earlier safety claims.
"This evidence has been intensely debated and has prompted many physicians to take a cautious approach in selecting patients for DES implantation."
Assoc Prof Ajani and colleagues found a 19 per cent reduction in DES use over the last 15 months of data analysed, and a 32 per cent reduction over the last 3 months.
"While DESs appear safe and were used in half of the procedures, there has been a recent reduction in their use," he said.
"The next step is to report on the safety of these stents 1 to 5 years after their insertion."