Drug Coated Stents Should be Avoided in Heart Attack PatientsSep 4, 2007 | Parker Waichman LLP, LLP
Drug coated stents might not be the safest option for heart attack patients, say the authors of a new study. The study, conducted by researchers at the Bichat-Claude Bernard Hospital in Paris, France, found that the risk of developing fatal blood clots related to the drug-eluting stents was highest in patients who had had a previous heart attack.
This latest study analyzed a patient database from 94 hospital in 14 countries. The authors of the study said that its findings indicated that heart surgeons should use caution when considering the use of drug coated stents in heart attack patients. The study looked at patients whose heart attack had resulted from a blood clot that completely blocked blood flow to the heart – the most damaging type of heart attack. Patients with the drug coated stents died at more than five of patients who received the bare metal stents. The researchers hypothesize that heart attack victims might have problems with the drug coated stents because blood vessels narrow following such a cardiac episode. This can lead to a gap around the stent – an ideal place for a blood clot to form.
Drug coated stents were developed as a way to keep blood vessels open after an angioplasty. Stents are lattice-like devices that act like scaffolding to hold a blood vessel open. The drug coating is supposed to keep scar tissue from closing the artery, a common problem with the bare metal version. However, this also prevents the artery from growing around the stent, and creates an ideal place for blood clots to form. The devices were approved in 2003 for use in patients with just one clogged vessel. But the stents were widely used off-label in sicker patients with multiple blockages or complicating illnesses, such as diabetes. However, since concerns over their safety were raised last year, the use of drug coated stents has decreased dramatically.
In 2006 the Cleveland Clinic published an analysis of fourteen stent studies covering more than 6,000 patients that found those with drug coated stents were four to five times more likely to suffer from blood clots than those implanted with bare metal stents. Earlier this summer, Dutch researchers released the results of a study that followed 75 patients after they had received multiple drug coated stents during multiple bypass operation. During the trial, 29-percrent of the patients using the drug coated stents died, while there were no fatalities among those who received the bare metal stents.
While this latest study suggest that drug coated stents should not be used in patients who have had a heart attack, there are ways to make them safer for others. One possible solution would be to have patients who received the drug –eluting stents to take anti-clotting medicines, like Plavix, for the rest of their lives. Surgeons should also reserve use the stents for simpler operations as they were intended, and forego the off-label practice of using these devices in patients with more complicated blockages.