Despite the recent burst of popularity for meta-analyses within the literature, the authors praise the careful analysis of drug-eluting stents
presented in this issue of the journal.
While drug-eluting stents
were initially proven more effective, they later suffered a setback because studies linked them to higher long-term death rates.
All myocardial infarcts were in the territory of a drug-eluting stent
in the right coronary artery.
7-8 to assess the risk of late stent thrombosis from drug-eluting stents
Despite their higher cost, and despite recent concerns about late thrombosis, drug-eluting stents
now own coronary stenting.
Brilakis said that some of the previous studies have indicated that patients receiving drug-eluting stents
in saphenous vein grafts may not reduce the risk of re-narrowing and may be associated with increased risk of death.
Based on current costs for drug-eluting stents
, and on their ability to cut target-vessel restenosis rates by about 80%, drug-eluting stents
will save money if they're used in patients with a restenosis rate of 18% or greater, and drug-eluting stents
will meet accepted definitions of cost-effectiveness (costing less than $10,000 for each repeat revascularization prevented) for all patients with a bare-metal stent restenosis rate of 12% or greater.
With more than 1,500 subjects, these randomized clinical trials showed that drug-eluting stents
can yield a 70%-90% reduction in restenosis rates across all categories of disease and all patient variables.
Both comparisons of drug-eluting stents
with brachytherapy involved stenoses in bare-metal stents, but drug-eluting coronary stents also worked for treating restenosis in drug-eluting stents
in a single-center series of 77 patients, which was reported in a poster at the meeting.
But this drug-eluting stent
was less successful by the angiographic measures that were collected in 89% of the first 600 patients enrolled in the study.