New Research Finds Drug-Eluting Stents Are More Effective for Heart Attack Patients Than Bare-Metal Stents
Boston, MA – Researchers from Brigham and Women’s Hospital (BWH) and Harvard Medical School (HMS), studying the long-term effectiveness of drug-eluting stents comp
ared to bare-metal stents among patients who had an acute heart attack, found that patients who received drug-eluting stents had significantly lower mortality rates after two-years compared to patients who received bare-metal stents. This study used the largest cohort and longest follow-up time to date for stent comparison research in the US. The findings appear in the September 25, 2008 issue of the New England Journal of Medicine.
The researchers followed 7,217 patients from Massachusetts who were treated with a stent for a heart attack between April 1, 2003 and September 20, 2004 (4016 with drug-eluting stents and 3201 with bare-metal stents). Each drug-eluting stent patient was matched with a similar bare-metal stent patient and followed for two years. Overall, death rates were two percent lower during this time for patients with drug-eluting stents. The death rate was further lowered (3.1 percent) for patients who had an acute heart attack and received a drug-eluting stent compared to those receiving a bare-metal stent for the same type of heart attack and again in cases of less acute heart attacks (2.9 percent). Additionally, rates of repeated stenting were significantly reduced during the two year span for all of those in the study who received a drug-eluting stent.
"Heart attacks are a life threatening condition where physicians need to decide quickly what the best way is to open the blocked artery. We conducted this study to understand whether drug-eluting stents are safe in this situation. It is very reassuring that drug-eluting stents were actually associated with better survival and fewer repeat procedures," said lead author Laura Mauri MD, an interventional cardiologist at Brigham and Women’s Hospital and an assistant professor at Harvard Medical School. Dr Mauri also cautioned, "Safe treatment with stents requires that patients are also able to take important medications like aspirin and other medicines that prevent clotting such as clopipdogrel, and so the choice of treatment still requires careful consideration of each individual patient’s condition.
Principle investigator of the study and professor of Health Care Policy at HMS, Sharon-Lise Normand added, "Through an effort headed by the Division of Health Care Quality at the Massachusetts Department of Public Health we were able to use clinical data collected from every hospital in the state that treats patients with stents to assess safety of the drug-eluting stents."
The research was part of a program that the Massachusetts Department of Public Health established in 2002 to examine the quality of cardiac care in Massachusetts hospitals. Dr. Paul Dreyer, Director of the Department's Bureau of Health Care Safety and Quality which oversees the program, said "The potential impact of this research on public health is an excellent example of the benefits of collaboration between government and academic institutions." Harvard Medical School serves as the cardiac data and research coordinating center for the Department's program.
The research was funded by the Massachusetts Department of Public Health.
Brigham and Women's Hospital (BWH) is a 777-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners HealthCare, an integrated health care delivery network. In July of 2008, the hospital opened the Carl J. and Ruth Shapiro Cardiovascular Center, the most advanced center of its kind. BWH is committed to excellence in patient care with expertise in virtually every specialty of medicine and surgery. The BWH medical preeminence dates back to 1832, and today that rich history in clinical care is coupled with its national leadership in quality improvement and patient safety initiatives and its dedication to educating and training the next generation of health care professionals. Through investigation and discovery conducted at its Biomedical Research Institute (BRI), BWH is an international leader in basic, clinical and translational research on human diseases, involving more than 860 physician-investigators and renowned biomedical scientists and faculty supported by more than $416 M in funding. BWH is also home to major landmark epidemiologic population studies, including the Nurses' and Physicians' Health Studies and the Women's Health Initiative. For more information about BWH, please visit www.brighamandwomens.org.
Harvard Medical School http://hms.harvard.edu has more than 7,500 full-time faculty working in 11 academic departments located at the School's Boston campus or in one of 47 hospital-based clinical departments at 18 Harvard-affiliated teaching hospitals and research institutes. Those affiliates include Beth Israel Deaconess Medical Center, Brigham and Women's Hospital, Cambridge Health Alliance, Children's Hospital Boston, Dana-Farber Cancer Institute, Forsyth Institute, Harvard Pilgrim Health Care, Hebrew SeniorLife, Joslin Diabetes Center, Judge Baker Children's Center, Immune Disease Institute, Massachusetts Eye and Ear Infirmary, Massachusetts General Hospital, McLean Hospital, Mount Auburn Hospital, Schepens Eye Research Institute, Spaulding Rehabilitation Hospital, and VA Boston Healthcare System.
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