Hospital Buyer

A study that was just published in the Journal of the American Medical Association describes the outcomes associated with stents, comparing drug eluting (DES) and bare metal stents (BMS). The study was completed in light of concerns that DES may be accompanied by an increased risk of stent thrombostenosis.

The study published presents findings from an observational study that included over 67,000 Medicare patients. All the patients had undergone stenting for nonemergent procedures. The trial compared findings from a group treated before DES were available to a cohort of patients treated after the development of such. The second study was randomized, patients received either DES or BMS.

A number of different outcomes were examined: ST-elevation heart attack, survival after two years of follow-up, and the rate of coronary revascularization. Findings from the trial indicate that there is a decrease in the rate of repeat procedures since the development of drug eluting stents. The rates of mortality and heart attack are essentially similar among the patients who received DES and BMS.

A commentary piece in Journal Watch Cardiology noted that the findings from this study are, perhaps, more powerful because of the statistical considerations. For example, the study was appropriately powered to detect differences between the groups. The trial also noted that the increased incidence of late thrombosis may actually be offset by the decreased risk of restenosis. This may call into question findings from previous trials, including one which was noted on HospitalBuyer from the New England Journal of Medicine.

June 30, 2008 Related topics: New Technology & Innovation, Quality, Safety, Errors, Cardiology