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Drug-coated stents carry higher clot risk?

Nov 29, 2006 | UPI The Cleveland Clinic said its analysis found that patients with drug-eluting stents have a higher risk of late thrombosis.

In fact, the Ohio-based center said patients implanted with the drug-coated devices designed to prevent re-closing of the coronary artery, a condition known as restenosis may have as much as a four- to five-fold greater risk for late thrombosis, or blood-clot formation, compared to patients implanted with the earlier generation, bare-metal stents.

"Our analysis found there is a small, but real, hazard of late stent thrombosis with drug-eluting stents more so than with bare-metal stents, likely in the setting of discontinuation of anti-clotting drugs," said Deepak Bhatt, associate director of the Cleveland Clinic's Cardiovascular Coordinating Center and one of the study's authors.

"This does not, however, mean that drug-eluting stents should not be used, as other studies have shown that they do significantly reduce the need for repeat procedures compared with bare-metal stents."

The meta-analysis focused on 14 studies involving 6,675 patients who had been implanted either with a sirolimus-coated or a paclitaxel-coated stent. Eight of those studies reported more than a year of clinical follow-up.

The patients with sirolimus-coated stents took anti-clotting medication for at least two to three months post-implantation, while the patients with paclitaxel-coated stents took clot-busting drugs for six months.

"The key to the controversy is likely careful patient selection," Bhatt said. "Further research is needed to determine how best to utilize drug-eluting stents and anti-clotting medications."

The study appears in the December issue of the American Journal of Medicine.

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