Study: Drug-coated stents better than bare metal stents

Johnson & Johnson's Cypher drug-coated stent
Sirolimus-eluting stents are better than bare metal and paclitaxel-eluting stents in lowering the heart attack risk for patients following angiography, according to study results published in the Sept. 15 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 drug-coated stent or a bare metal stent.

The study is the first to include all direct and indirect evidence from all randomized controlled studies that pit the stents against one another 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 follow-up of up to four years. The researchers also considered additional data on clinical outcomes for 29 trials.

The researchers from the Institute of Social and Preventive Medicine at 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 with bare metal stents, and had a 17 percent lower risk than paclitaxel-eluting stents 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.

The Swiss National Science Foundation funded the study.