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Drug-coated heart stents carry higher risk: study

By Sheba     Mar 25, 2007 in Health
A study released on Saturday says that drug-coated heart stents carry a small but significantly greater risk of blood clots and heart attacks compared to the older bare-metal medical devices.
The study also concluded that the stents' benefits outweighs the risk of blood clots and heart attacks which are greater between the first 12 months to 15 months following implantation. These devices are used to prop open surgically cleared arteries.
"Even in a short three-month period, you saw a trend," toward increased blood clotting, said Spencer King, head of interventional cardiology at Atlanta Piedmont Hospital.
The results in this study will add to the growing debate regarding the use of the drug-coated stents versus the bare-metal stents. The drug-coated devices are more popular as they also help to prevent re-narrowing of the arteries which may occur in patients receiving the older bare-metal devices.
Three years ago the drug-coated version of the device was introduced and it quickly replaced the bare-metal type. A stent is a meshed tube inserted into the artery to keep it open so blood may flow unobstructively, thereby preventing a heart attack.
The safety of the device came under question earlier on as data revealed the formation of blood clots long after implantation. Total mortality for both groups was similar although patients with drug-coated stents showed a 43 percent reduction in repeat procedures.
The newer, more pricey versions were seen as a medical breakthrough and created a $6 billion market for stent-makers Johnson & Johnson and Boston Scientific
The Denmark study which looked at 12,400 patients who were randomly given bare-metal or drug-coated devices found the rate of blood clots and heart attacks were similar over the first 15 months period after implantation.
However, over the last three months of that period, an increased risk of blood clotting and heart attack was seen with drug-coated stents.
Study author, Michael Maeng indicated that further study is needed to determine if "the very small excess of stent thrombosis (blood clotting) and heart attack in the 12 to 15 month time period will continue to increase."
"The follow-up may still be insufficient to completely quantify possible risks" of blood clotting, he added.
He also said the increased risk of clotting was so small that it did not outweigh the device's benefits, including the need for fewer new procedures.
Concerns over blood clots however, has seen a drop in the stent market from 95 percent about a year ago to about 70 percent at present.
My, at the time, 78 year old mom had this device implanted in her. She is now 81, so she would have received the bare-metal device as the drug-coated ones were either not yet introduced or just being introduced.
We were advised by the doctors that there were risks and that the first two years after the implantation were critical. The stent is expected to last about 10 years.
She is doing well and we're just happy to have her around with us still. She survived two heart attacks. She still lives on her own, still cooks and cleans too (although we help out too). Bless her heart - literally. :-)
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