Featured Research

from universities, journals, and other organizations

Medication-releasing Stent Reduces Risk Of Artery Re-narrowing Following Angioplasty

Date:
September 19, 2005
Source:
JAMA and Archives Journals
Summary:
Compared to bare metal stents, placement of stents that release the medication paclitaxel reduces the risk of the artery re-narrowing nine months following angioplasty for patients with complex coronary artery lesions, according to an article in the September 14 issue of JAMA.

Compared to bare metal stents, placement of stents that release themedication paclitaxel reduces the risk of the artery re-narrowing ninemonths following angioplasty for patients with complex coronary arterylesions, according to an article in the September 14 issue of JAMA.

Drug-eluting stents have revolutionized the treatment ofatherosclerotic coronary artery disease, according to backgroundinformation in the article. These stents (which release medications,such as sirolimus and paclitaxel) have been shown to safely reduceclinical and angiographic restenosis (narrowing again of the arteryafter treatment) compared with bare metal stents. Enrollment in thetrials for these stents, however, was restricted to relatively simplestenoses (vessel diameter of 2.5-3.75 mm with lesion length 30 mm orless). More than 55 percent of lesions currently treated with thesebioactive devices may fall outside this range. The efficacy ofdrug-eluting stents has not been established for small vessels (inwhich the utility of stents as a class is still uncertain), largevessels (in which outcomes with bare metal stents are favorable), or inlong lesions requiring multiple stents.

Gregg W. Stone, M.D., of Columbia University Medical Center andCardiovascular Research Foundation, New York, and colleagues conducteda study (the TAXUS V trial) to investigate the safety and efficacy of apaclitaxel-eluting stent in a patient population with more complexcoronary lesions than previously studied. The trial, conducted fromFebruary 2003 to March 2004 at 66 academic and community-basedinstitutions, included 1,156 patients who underwent stent implantationin a single coronary artery stenosis (vessel diameter, 2.25-4.0 mm;lesion length, 10-46 mm), including 664 patients (57.4 percent) withcomplex or previously unstudied lesions (requiring 2.25-mm, 4.0-mm,and/or multiple stents) and had 9-month clinical and angiographicfollow-up. Patients were randomly assigned to receive 1 or more baremetal stents (n = 579) or identical-appearing paclitaxel-eluting stents(n = 577).

The average reference vessel diameter was 2.69 mm, thereference lesion length was 17.2 mm. An average of 1.38 stents (totalaverage length, 28.4 mm) were implanted per lesion. Stents of 2.25 mmand 4.0 mm in diameter were used in 18 percent and 17 percent oflesions, respectively; multiple stents were used in 33 percent oflesions.

"Compared with bare metal stents, implantation ofpaclitaxel-eluting stents reduced the 9-month rate of target lesionrevascularization from 15.7 percent to 8.6 percent and target vesselrevascularization from 17.3 percent to 12.1 percent. Among patientsreceiving the paclitaxel-eluting stent compared with a bare metalstent, the rate of in-stent restenosis was reduced with from 31.9percent to 13.7 percent and analysis segment angiographic restenosiswas reduced from 33.9 percent to 18.9 percent," the authors write.

"By multivariate analysis, randomization to thepaclitaxel-eluting stent was an independent predictor of freedom from9-month target lesion revascularization [2.2 times more likely], targetvessel revascularization [1.7 times more likely], and restenosis [2.9times more likely]. These benefits were achieved with comparable safetyin both groups, with similar rates of cardiac death, myocardialinfarction, and stent thrombosis at 1 and 9 months."

Angiographic restenosis was also reduced among patientsreceiving 2.25-mm stents (49.4 percent vs. 31.2 percent), 4.0-mm stents(14.4 percent vs. 3.5 percent), and multiple stents (57.8 percent vs.27.2 percent).

"In conclusion, the TAXUS V trial investigated the use ofpaclitaxel-eluting stents in a patient population with more complexlesions than had been previously studied. Angiographic restenosis andtarget vessel revascularization were significantly reduced in theentire cohort, as well as in those patients with complex disease," theauthors write.

###

(JAMA. 2005; 294:1215-1223. Available pre-embargo to the media at www.jamamedia.org)

Editor's Note: This study was sponsored and funded by BostonScientific Corp., Natick, Mass. For the financial disclosures of theauthors, please see the JAMA article.

Editorial: Paclitaxel-Eluting Stents in Complex Lesions

In an accompanying editorial, Antonio Colombo, M.D., and JohnCosgrave, M.D., of the Columbus and San Raffaele Hospitals, Milan,Italy, comment on the study by Stone et al.

"It is becoming increasingly clear that drug-eluting stentshave not abolished the restenotic process, and especially in high-risklesions, target vessel revascularization rates exceed 10 percent. Thissuggests that while the two most studied stents are a vast improvementover the bare metal stent, there is still room for further progress.Perhaps thinner strut stents or drug combinations may hold the key todecrease restenosis even further. Finally, there is the huge challengeof reducing myocardial infarction and death following percutaneouscoronary intervention and stent placement. The next step is to movefrom the complex lesion to the complex patient," the authors write.

(JAMA. 2005; 294:1268-1270. Available pre-embargo to the media at www.jamamedia.org.)


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Cite This Page:

JAMA and Archives Journals. "Medication-releasing Stent Reduces Risk Of Artery Re-narrowing Following Angioplasty." ScienceDaily. ScienceDaily, 19 September 2005. <www.sciencedaily.com/releases/2005/09/050918132442.htm>.
JAMA and Archives Journals. (2005, September 19). Medication-releasing Stent Reduces Risk Of Artery Re-narrowing Following Angioplasty. ScienceDaily. Retrieved July 31, 2014 from www.sciencedaily.com/releases/2005/09/050918132442.htm
JAMA and Archives Journals. "Medication-releasing Stent Reduces Risk Of Artery Re-narrowing Following Angioplasty." ScienceDaily. www.sciencedaily.com/releases/2005/09/050918132442.htm (accessed July 31, 2014).

Share This




More Health & Medicine News

Thursday, July 31, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Health Insurers' Profits Slide

Health Insurers' Profits Slide

Reuters - Business Video Online (July 30, 2014) Obamacare-related costs were said to be behind the profit plunge at Wellpoint and Humana, but Wellpoint sees the new exchanges boosting its earnings for the full year. Fred Katayama reports. Video provided by Reuters
Powered by NewsLook.com
Concern Grows Over Worsening Ebola Crisis

Concern Grows Over Worsening Ebola Crisis

AFP (July 30, 2014) Pan-African airline ASKY has suspended all flights to and from the capitals of Liberia and Sierra Leone amid the worsening Ebola health crisis, which has so far caused 672 deaths in Guinea, Liberia and Sierra Leone. Duration: 00:43 Video provided by AFP
Powered by NewsLook.com
At Least 20 Chikungunya Cases in New Jersey

At Least 20 Chikungunya Cases in New Jersey

AP (July 30, 2014) At least 20 New Jersey residents have tested positive for chikungunya, a mosquito-borne virus that has spread through the Caribbean. (July 30) Video provided by AP
Powered by NewsLook.com
Xtreme Eating: Your Daily Caloric Intake All On One Plate

Xtreme Eating: Your Daily Caloric Intake All On One Plate

Newsy (July 30, 2014) The Center for Science in the Public Interest released its 2014 list of single meals with whopping calorie counts. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

    Environment News

    Technology News



      Save/Print:
      Share:

      Free Subscriptions


      Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

      Get Social & Mobile


      Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

      Have Feedback?


      Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
      Mobile: iPhone Android Web
      Follow: Facebook Twitter Google+
      Subscribe: RSS Feeds Email Newsletters
      Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins