Better Outcomes for Stents When Fractional Flow Reserve (FFR) is Used -- Angioplasty.Org
Routine measurement of FFR in patients with multivessel coronary artery disease who are undergoing PCI with drug-eluting stents significantly reduces the rate of the composite end point of death, nonfatal myocardial infarction, and repeat revascularization at 1 year.

The result was that one-third fewer stents were used in the FFR group and the difference in outcomes at one year were significant: the FFR group showed a 28% lower incidence of major adverse cardiac events (repeat procedure to open the artery, heart attack or death) -- 18.3% vs. 13.2%. The implication in these results is that placing stents in lesions that are not responsible for ischemia is not only not necessary, but may cause worse outcomes.

So the insertion of stents where they are not needed CAUSED deaths. That's not reassuring.
New Tool Could Prevent Needless Stents and Save Money, Stanford Cardiologist Says - MarketWatch
Doctors may be implanting too many artery-opening stents and could improve patient outcomes--and ultimately save lives--if they did more in-depth measurements of blood flow in the vessels to the heart.
Statins Raise Prostate Cancer Risk of Obese Men
A study conducted earlier this year at the Fred Hutchinson Cancer Research in Seattle found that the use of cholesterol-lowering statin drugs, especially when used long-term, seems to raise the risk of prostate cancer among obese men.
RPT-Crestor study seen changing preventive treatment | Industries | Healthcare | Reuters
A study that showed AstraZeneca's cholesterol fighter Crestor slashed deaths, heart attacks, strokes and artery-clearing procedures in apparently healthy patients has made a dramatic impression on some doctors who now expect an adjustment to preventive care guidelines.
Drug-eluting stents more effective, equally as safe as bare metal ones
These results provide definitive evidence that drug-eluting stents are superior in efficacy to bare metal stents and have a comparable safety profile at 1 year.
Drug-Eluting Stents Versus Bare Metal Stents for Narrowing in Saphenous Vein Grafts
Conclusions: There is no significant benefit of using DES in patients undergoing percutaneous coronary intervention of SVG lesions. Science
Boston Scientific Corp.'s Taxus stent wasn't as good as bypass surgery in improving the outcome of the sickest patients with a build-up of fatty deposits in their arteries, doctors said today....After one year, 12.1 percent of bypass patients had either died, experienced a heart attack or stroke, or had to have a repeat operation, compared with 17.8 percent of those who received a tube to prop open a clogged artery, cardiologists led by Patrick Serruys at Erasmus University in Rotterdam said at the European Society of Cardiology meeting in Munich today.
News|In-stent restenosis best corrected with drug-eluting stent Source: Reuters Author: Martha Kerr
The risk of restenosis is significantly lower when revascularization is achieved with a paclitaxel-eluting stent than by vascular brachytherapy for a bare metal stent in-stent restenosis, according to the two-year findings of the TAXUS V-ISR multicenter trial.
News|In-stent restenosis best corrected with drug-eluting stent | Source: Reuters Author: Martha Kerr
Study Suggests Right Type of Stent for Clogged Coronary Artery
Researchers found that clotting problems were twice as likely to happen with drug-coated stents as with bare-metal ones. However, a longer-term analysis showed no significant difference three years after surgery.
Angioplasty will be more popular soon: Expert -
...the experiments in cardiology in the developed countries since 2000 had found that implantation of drug eluting stents through angioplasty procedures to correct blocks in veins had many advantages over the bypass surgery.
» Drug-coated cardiac stents better: study - Thaindian News
Heart patients who have received drug-coated stents to open their blocked coronary arteries have a healthier future, according to new research. Researchers at the University of Pennsylvania found that patients with drug-coated stents were less apt to die, have another heart attack or require extra stents or bypass surgery in the two years following the first placement, compared to those who receive bare metal stents.
NRM: Biodegradable stent aces trial
A drug-eluting stent that vanishes when its work is done is a step closer to market thanks to a successful clinical trial. The first ever clinical data on the device appeared in the March 15 issue of The Lancet and the results are very promising.
Stents vs. Bypass Surgery for Coronary Artery Disease
"However, as almost every previous similar study has shown, patients who received stents were nearly 5 times as likely to require subsequent interventions to clear and open re-clogged coronary arteries after stenting, when compared to the patients that had their narrowed coronary arteries completely bypassed by CABG surgery."
Scanner to Find Fatty Deposits in Vessels Is Approved - New York Times
Federal regulators have approved the sale of a new laser scanning system intended to locate fatty deposits in blood vessel walls that are thought to cause heart attacks.
Drug-Coated Stents Safe, Study Concludes -
Doctors can safely use drug-coated stents to open up complicated blockages in coronary arteries for which the devices were not originally designed, according to new research. In fact, they appear to work better than older, bare-metal stents in those situations.
Study: Certain stents are safer --
People with drug-coated stents were less likely to die or suffer heart attacks within two years than those treated with plain metal devices....But the new study showed "bare" stents had higher rates of death and heart attacks at two years after implantation than devices dipped in medicine.
Drug-coated stents better than naked stents, study says | Seattle Times Newspaper
People with drug-coated stents were less likely to die or suffer heart attacks within two years than those treated with plain metal devices, according to research presented Sunday in Orlando.
Not Worth The Money - Drug-Coated Stents
According to Swiss research published in The Lancet, pricey drug-coated stents are not worth their cost...Stents, which are coated with and elute drugs, are often used to open up clogged coronary arteries. According to the research, these devices are not particular useful in decreasing heart complications or elongating lives, at least in proportion to their costs. At the same time, the researchers noted that the devices could be cost-effective in
Study: New heart pill beats Plavix
A new blood thinner proved better than Plavix, one of the world's top-selling drugs, at preventing heart problems after procedures to open clogged arteries, doctors reported Sunday. But the new drug also raised the risk of serious bleeding.
Study finds drug-coated stents safe for high-risk patients - MarketWatch
A study published Wednesday in a leading medical journal has found that the use of drug-coated rather than bare-metal stents resulted in the need for fewer repeat procedures and did not significantly raise the risk of heart attack in certain high-risk patients.
Making sense of stents: Physicians debate the benefits and risks - 06/26/2007 -
"When the FDA approved a new kind of cardiac stent coated with time-release drugs to keep newly opened arteries from reclogging with plaque, many saw the stents as a miracle. Now cardiologists are debating whether the stents, when improperly used, might put patients at greater risk of blood clots, heart attacks, even death."
Report Rates Hospitals on Their Heart Treatment - New York Times
The federal government has gingerly stepped back into rating the care delivered by the nation's hospitals, releasing for the first time in nearly two decades a list of hospitals where heart patients are most likely to die.
VOA News - Stent Failure: How Much of the Problem Is Caused by Doctors?
One recent study found that stents were incorrectly placed in almost 70 percent of the patients in that study.
Drugs in comeback against artery stents | Chicago Tribune
Metal devices that doctors snake through blood vessels to keep them unclogged are reaching a crossroad as a study indicates that cholesterol medications and aspirin may be as effective.
Biodegradable stents claimed to be successful in small trial
Researchers from the West German Heart Center in Essen have reported success with using a biodegradable stent that is made of magnesium. The details of their study using these stents are published in the June 2 issue of The Lancet....Stents are meshed devices that are implanted into blocked arteries so as to allow a smoother flow of blood and prevent unwanted complications. Usually stents are made of metal. But scientists across the world are trying to create biodegradable stents that can be broken up by the body once they successfully overcome the block issue.
Doctor's invention gets FDA approval Stent hailed as boost to area's life-sciences image-
A device to help physicians more accurately place stents in coronary and renal artery-opening procedures has been approved by the Food and Drug Administration...That news is important for heart patients and their doctors, but the men who brought the device to market said it also is good news for the area's life sciences and biotech businesses.
Cardiovascular Medicine » 45 Drug-Eluting Coronary Stents: Analysis of 14 trials comparing sirolimus-eluting stents with bare-metal stents (see p1031)
The purpose of this study [1] was to determine the long-term outcome after implantation of sirolimus-eluting stents (Cypher or Cypher Select, Cordis) based on data from individual patients from randomized clinical trials that compared this device with bare-metal stents (BMS).
In the Stent Era, Heart Bypasses Get a New Look - New York Times
After more than a decade-long decline, is heart bypass surgery poised for a comeback?
Angioplasty.Org IVUS NewsCenter
"Two-thirds of the stents that are placed nowadays are not properly deployed."...While the focus has been on the stent devices as a possible cause of late stent thrombosis (blood clots occurring many months or years after implantation) attention may now be shifting to "overconfidence" on the part of interventional cardiologists that has led to "sloppy" and "poor technique."
High-Tech Images Can Reveal Stent Status -
Newer multislice computed tomography scanners can yield images that show whether a heart patient's stent has become blocked. This technology potentially eliminates the need for inserting a catheter to perform invasive angiography, Dutch cardiologists report.
WDDTY | Stents: 25 years on and specialists learn that lifestyle changes are just as effective
A new trial, involving 2,297 heart patients with at least one blocked coronary artery, found that they fared just as well if they stopped smoking, exercised, and improved their diet....They lived as long, if not longer, than the patients who were given a stent, but who otherwise carried on as before, and their quality of life was also far higher.
Moody's may cut Boston Scientific to junk status
Moody's Investors Service on Wednesday said it may downgrade Boston Scientific Corp.'s (BSX.N: Quote, Profile , Research) debt rating to junk status, citing lower sales of the company's stents for heart patients.
In the Stent Era, Heart Bypasses Get a New Look - New York Times
We as cardiologists have probably pressed forward on stent technology a little faster than we should have, said Dr. Kirk Garratt.
Stents and MRI scans - Entrez PubMed
The number of coronary stents may be over half a million world-wide. The neurologist and radiologist are frequently confronted with cardiac patients who have had a recent carotid or coronary stent implanted and present with an acute and unrelated stroke for which an MRI is recommended. We have reviewed and classified all the major stents currently available world-wide and discussed their interaction with MRI through their ferro-magneticity. All current stents are MRI safe and MRI can be done anytime.
Drugs Work as Well as Stents, Study Finds - New York Times
Many heart patients routinely implanted with stents to open arteries gain no lasting benefit compared to those treated with drugs alone, researchers are reporting today....The researchers said that patients who received stents to prop open coronary blood vessels in addition to being treated with statins and other heart drugs during a five-year clinical trial had better blood flow to their heart than those treated only with drugs. But they did not live longer or have fewer heart attacks.
NEJM -- Long-Term Outcomes with Drug-Eluting Stents versus Bare-Metal Stents in Sweden
Conclusions Drug-eluting stents were associated with an increased rate of death, as compared with bare-metal stents. This trend appeared after 6 months, when the risk of death was 0.5 percentage point higher and a composite of death or myocardial infarction was 0.5 to 1.0 percentage point higher per year. The long-term safety of drug-eluting stents needs to be ascertained in large, randomized trials.
Charleston Daily Mail
"The drug-eluting stent is extremely safe, and the number of patients who are adversely affected is less than 1 percent,"
NEJM -- A Pooled Analysis of Data Comparing Sirolimus-Eluting Stents with Bare-Metal Stents
Conclusions In a pooled analysis of data from four trials comparing sirolimus-eluting stents and bare-metal stents, no significant differences were found between the two treatments in rates of death, myocardial infarction, or stent thrombosis.
Drug-coated arterial stents have been given bad rap, doctor contends
"It's important to prevent renarrowing. Putting in drug-coated stents prevents the re-narrowing of arteries at the small cost of possible late clotting." "With bare metal stents, the risk of clotting takes place in the first two to four weeks," Mishkel said. "With drug-eluding stents, the risk happens late, six months to two years later." "...risk of a heart attack in those patients is "no different" than patients with bare metal stents."
Drug-eluting stents: Do they increase heart attack risk? -
"It's important to remember that in all circumstances studied so far, drug-eluting stents have been shown to be more effective than bare-metal stents, with less risk of restenosis and the associated risk of more procedures. Keep in mind that compared to bare-metal stents, drug-eluting stents dramatically reduce the chances your arteries will become clogged again." EXCELLENT summary on safety of drug-eluting stents.
Stents placement may help people at high stroke risk
A study published in the American Academy of Neurology has found that stents placement may be beneficial for people who are at a higher risk of stroke due to blocked blood vessels in the brain.
United Press International - Health Business - Study: Drug-eluting stents cut death rate
"This study is worthy of note because it shows a significant advantage for drug-eluting stents over bare-metal stents with lower rates of death and heart attack as well as lower rates of re-intervention," said Paul LaViolette, chief operating officer of Boston Scientific. "These findings are consistent with results shown in the Taxus clinical program and suggest further that the benefit of drug-eluting stents may be even greater in real-world patients."
Angioplasty.Org NewsCenter
Antiplatelet Medications Should Be Continued For Patients Who Receive Drug-Eluting Stents
"Despite this benefit, antiplatelet therapy is sometimes prematurely discontinued within the first year after stent implantation," the advisory warns. This practice is potentially deadly. Stopping antiplatelet therapy too early after a stent is placed is the leading independent predictor of stent thrombosis - blood clots that frequently lead to heart attack and/or death. "Death rates due to presumed or documented stent thrombosis range from 20 percent to 45 percent," the advisory reports.
Take drugs a year after stents - Health
'We want to alert patients and healthcare professionals that this is a serious medical issue; they shouldn`t even think about stopping anti-platelet therapy because it could result in heart attack or death,' said Cindy Grines, a cardiologist at William Beaumont Hospital in Royal Oak, Mich. | 01/02/2007 | Study reveals danger of some heart stents
Drug-coated stents may hinder the heart's natural ability to form tiny collateral blood vessels that can salvage heart muscle by rerouting the blood supply, according to a new study.
Drug-Eluting Stents Risky Without Blood Thinner, Study Suggests
FDA Probes Safety of Popular Heart Stent
Stent Procedure at American Heart Association
Drug-coated stents facing hard 2d look - The Boston Globe
FDA Panel Gets Set for Drug-Eluting Stent Safety Hearing
NPR : FDA Weighs Risks, Benefits of Drug-Coated Stents
FDA Statement on Coronary Drug-Eluting Stents

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