Study: Drug-coated stents better than bare metal stents

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Sirolimus-eluting stents seem to be clinically better than bare metal and paclitaxel-eluting stents in lowering the heart-attack risk for patients whose arteries were opened, according to study results published in the September issue of The Lancet. Therefore, the study endorses the use of Johnson & Johnson’s (J &J) Cypher, a drug-coated stent, versus Boston Scientific’s Taxus, a bare metal device.

The study is the first to include all direct and indirect evidence from all randomized controlled studies that pit the stents against each other or against bare-metal devices, according to the Wall Street Journal ( WSJ).

The intention of the researchers was to assess the safety and effectiveness of the various stents in patients with coronary artery disease. The study included 38 trials and 18,023 patients, with a follow-up of up to four years. The researchers also considered additional data on clinical outcomes for 29 trials from trialists and manufacturers.

The researchers from the University of Bern in Switzerland, and other institutions throughout Europe, Asia and the United States, found that the mortality rate was similar in the various groups. Yet, sirolimus-eluting stents, produced by J &J, were associated with the lowest risk of heart attack (19 percent) in comparison to bare metal stents (17 percent), produced by Boston Scientific.

The WSJ reported that safety issues and a previous study questioning the need for stents have contributed to substantial declines in sales for Boston Scientific and J &J devices. J &J's stents posted $450 million in overall sales in the second quarter, down about 35 percent from a year earlier and Boston Scientific's stent sales fell 32.5 percent in the quarter to $437 million, according to the WSJ.

Swiss National Science Foundation funded the study.