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Drug coated stents better than plain metal stents for heart attack patients: Study

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Tuesday, September 29, 2009, 12:10 This news item was posted in medical devices category and has 0 Comments so far.

Drug coated stent (paclitaxel) is safer and more effective than a bare-metal stents, report studies.

An anti-blood clotting drug bivalirudin enhanced safety and efficacy compared to the use of heparin + GPIIb/IIIa inhibitors. Related: Drug stents better than plain stents

Anti-blood clotting bivalirudin alone compared to heparin plus GPIIB/IIIa inhibitors resulted in a significant 36 percent reduction in major bleeding and a significant 25 percent reduction in reinfarction, with comparable rates of stent thrombosis, TVR and stroke.

Drug coated with bivalirudin led to a significant 41 percent reduction in cardiac mortality and a 25 percent reduction in all-cause mortality, the latter representing 15 lives saved per 1,000 patients treated.

Stents coated with drug paclitaxel compared to a bare-metal stent resulted in significant 42 percent and 34 percent reductions in ischemic target lesion revascularization and target vessel revascularization respectively.

“The results at two years are more impressive than both the initial 30-day and the one year results that we reported at target vessel revascularization last year,” said Gregg W. Stone, MD, immediate past chairman of CRF, professor of medicine at Columbia University Hospital and Director of Cardiovascular Research and Education at the Center for Interventional Vascular Therapy at NewYork-Presbyterian Hospital/Columbia University Medical Center.

Previous studies of drug-eluting stents have often focused on their use in patients with stable or unstable chest pain, this is the largest study to focus on the appropriate use of anticoagulation medications and drug-eluting stents in patients experiencing the most dangerous form of heart attack.

Results from “Two-Year Follow-up from a Prospective, Randomized Trial of Heparin Plus Glycoprotein IIb/IIIa Inhibitors vs. Bivalirudin and Paclitaxel-Eluting vs. Bare Stents in STEMI” will be presented at TCT.

The Cardiovascular Research Foundation (CRF) is a nonprofit organization dedicated to improving the survival and quality of life for people with cardiovascular disease through research and education.

Transcatheter Cardiovascular Therapeutics (TCT) is the annual scientific symposium of the Cardiovascular Research Foundation. TCT gathers leading medical researchers and clinicians from around the world to present and discuss the latest developments in the field of interventional cardiology and vascular medicine.

Data from the landmark HORIZONS-AMI clinical trial, presented at the 21st annual Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium, demonstrated that after two years, in heart attack patients,use of a drug-eluting stent (paclitaxel) was safer and more effective than a bare-metal stent; and that the administration of the anticoagulant medication bivalirudin enhanced safety and efficacy compared to the use of heparin + GPIIb/IIIa inhibitors.

HORIZONS AMI (Harmonizing Outcomes with RevascularIZatiON and Stents in Acute Myocardial Infarction was sponsored by the Cardiovascular Research Foundation, with research grant support from Boston Scientific Corporation and The Medicines Company.HORIZONS AMI trial enrolled over 3,600 patients presenting with a heart attack to hospitals in 11 countries. More than 120 national and international interventional cardiology centers participated in the trial. Patients undergoing angioplasty were randomly assigned to receive the prior standard anticoagulant regimen of unfractionated heparin plus a glycoprotein IIb/IIIa inhibitor or bivalirudin alone.

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