Featured Research

from universities, journals, and other organizations

Bare-metal Stents Are Better For Some Heart Patients

Date:
May 12, 2007
Source:
Thomas Jefferson University
Summary:
While drug-eluting stents are effective in keeping open diseased heart arteries, they should not be used for patients who need to have noncardiac surgery a short time after an interventional heart procedure. New research indicates that for these patients, bare metal stents provide a safer choice.

While drug-eluting stents are effective in keeping open diseased heart arteries, they should not be used for patients who need to have non-cardiac surgery a short time after an interventional heart procedure. A presentation at the Society for Cardiovascular Angiography and Interventions in Orlando by cardiologists at Jefferson Medical College indicates that for these patients, bare metal stents provide a safer choice.

"The issue here," says Michael Savage, M.D., Catheterization Laboratory Director at Thomas Jefferson University Hospital in Philadelphia, "is that studies have demonstrated that those patients who receive drug-eluting stents may develop life-threatening cardiac complications if they undergo subsequent, non-cardiac surgery."

This prescription for the potentially deadly problem begins when a person, often a senior citizen, learns that she or he must have elective surgery. The surgery can be for a minor to a major problem--from vacular surgery to fix blood flow problems, to broken hips or bones, neurological or urological issues and more.

Often, severe coronary artery disease is discovered during the pre-surgical testing. If severe, it presents a more-immediate problem and therefore, must be treated before the patient undergoes the elective surgery.

Prior studies have shown that patients may suffer fatal heart attacks due to clotting inside of the stents when surgery is performed within a few weeks after stent placement. In the case of drug-eluting stents, clotting of the stent may occur even months or years after their heart procedure, particularly when their blood thinning medicine (usually aspirin and Plavix) are stopped before the surgery.

To avoid the potentially deadly scenario, the Jefferson Medical College researchers developed a clinical protocol to enable patients to have both procedures successfully with little risk. Led by Agostino Ingraldi, M.D., a fellow in cardiovascular diseases, they developed the following four-part strategy:

  • Avoidance of drug-eluting stents in favor of bare metal stents during the interventional heart procedure.
  • A four-week course of the blood thinner clopidogrel (Plavix) after an interventional heart procedure.
  • Deferral of the second, non-cardiac surgery for five to 12 weeks after the interventional procedure.
  • Discontinuation of clopidogrel (Plavix) at least five days prior to the non-cardiac surgery.

The researchers studied a total of 60 patients (33 men and 27 women) who averaged 68 years old and who were treated with the strategy. Twenty seven percent suffered from diabetes which can complicate surgery.

The results show the coronary interventional procedure was successful in all patients where a total of 82 heart lesions were treated with bare-metal stents. The second, non-cardiac, surgery was performed an average of 47 days later. All were performed under general anesthesia and were successful. There were no deaths or clotting leading to problems. Also, clotting of the stents--a major problem seen with drug-eluting stents in this setting--were not seen in any patient.

"This research provides a safe treatment strategy for interventional cardiologists and their patients who will be undergoing further surgery," adds Dr. Savage, who is also associate professor of Medicine, Jefferson Medical College of Thomas Jefferson University. "Drug-eluting stents have proven benefits but may not be the best solution for every patient."

Members of the team who conducted this study at Thomas Jefferson University Hospital in Philadelphia, Pa., are:

  • Agostino Ingraldi, M.D., Nicholas J. Ruggiero II, M.D., Mark Awar, M.D.,
  • Saum Shamimi-Noori, M.D., Utpal Sager, M.D., David Fischman, M.D.,
  • Paul Walinsky, M.D., Howard H. Weitz, M.D., and Michael Savage, M.D.

Story Source:

The above story is based on materials provided by Thomas Jefferson University. Note: Materials may be edited for content and length.


Cite This Page:

Thomas Jefferson University. "Bare-metal Stents Are Better For Some Heart Patients." ScienceDaily. ScienceDaily, 12 May 2007. <www.sciencedaily.com/releases/2007/05/070511203219.htm>.
Thomas Jefferson University. (2007, May 12). Bare-metal Stents Are Better For Some Heart Patients. ScienceDaily. Retrieved August 28, 2014 from www.sciencedaily.com/releases/2007/05/070511203219.htm
Thomas Jefferson University. "Bare-metal Stents Are Better For Some Heart Patients." ScienceDaily. www.sciencedaily.com/releases/2007/05/070511203219.htm (accessed August 28, 2014).

Share This




More Health & Medicine News

Thursday, August 28, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

CDC Director On Ebola Outbreak: 'It's Worse Than I Feared'

CDC Director On Ebola Outbreak: 'It's Worse Than I Feared'

Newsy (Aug. 28, 2014) CDC director Tom Frieden says the Ebola outbreak is even worse than he feared. But he also said there's still hope to contain it. Video provided by Newsy
Powered by NewsLook.com
Treadmill 'trips' May Reduce Falls for Elderly

Treadmill 'trips' May Reduce Falls for Elderly

AP (Aug. 28, 2014) Scientists are tripping the elderly on purpose in a Chicago lab in an effort to better prevent seniors from falling and injuring themselves in real life. (Aug.28) Video provided by AP
Powered by NewsLook.com
Japan's Golden Generation Shows No Sign of Slowing Down

Japan's Golden Generation Shows No Sign of Slowing Down

AFP (Aug. 27, 2014) For many people in the autumn of their lives, walking up stairs is the biggest physical challenge they face. But in Japan, race tracks, hammer or pole vault await competitors at the Kyoto Masters, some of them more than 100 years old. Duration: 02:32 Video provided by AFP
Powered by NewsLook.com
Mini Pacemaker Has No Wires

Mini Pacemaker Has No Wires

Ivanhoe (Aug. 27, 2014) Cardiac experts are testing a new experimental device designed to eliminate major surgery and still keep the heart on track. Video provided by Ivanhoe
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