Safer, more effective stents will be available next week for patients with clogged arteries

Wake Forest University Baptist Medical Center will be one of the first medical centers in the region to begin using a new generation of drug-coated stents next week following a major study and the Food and Drug Administration's approval of their use.

Robert J. Applegate, M.D., professor of cardiology and the principal investigator of the study at Wake Forest Baptist, said that the Medical Center was one of 65 participating in a series of trials that showed that the newer version of drug-eluting stent worked best because it is a thinner stent, has a gentler coating, and eludes a more effective dose of medication.

Stents are thin mesh scaffolds inserted into the arteries through a catheter that are used to keep the arteries of chest pain patients open and clear of blood clots.

"Stent therapy has been a major advance in the treatment of patients with symptomatic coronary artery disease," Applegate said. "The addition of medication released from the stent into the blockage further improved the stent therapy, translating into better results, including fewer repeat procedures. Wake Forest University Baptist Medical Center was one of the first to report that drug-eluting stents also appeared to result in fewer heart attacks and deaths compared to stents without medication."

The stent that proved superior in the most recent trial is called Xience V and is made by Abbott Laboratories.

"Since the introduction of the first generation of drug-eluting stents, thinner stents have been designed that are much easier to place in the coronary arteries, and are gentler on the artery," said Applegate. "The newest version not only incorporates a thinner stent, but also uses less overall medication and employs a gentler coating.

"The combination of all of these newer features in a single stent will likely result in better outcomes for the patients who receive them, including fewer repeat procedures, heart attacks and deaths, compared to the currently used drug-eluting stents. All of this information should be reassuring to patients that the new stent therapy should be both effective and safe."

The results comparing two versions of stents were reported in May at the EuroPCR 2008 meeting in Barcelona, Spain. That study found that the Xience V stent had a 43 percent reduction in the risk of major cardiac events, a 32 percent reduction in the risk of vessel failure, and lower rates of stent thrombosis.

The Heart Center at Wake Forest Baptist, which has participated in nine such clinical trials since 2001, did its own evaluation of patient outcomes and reported that the benefit found with the use of drug-eluting stents at nine months was still present at two years.

http://www.wfubmc.edu