Cardiology

DES is Safe and Effective: Study

The study revealed that for a period of one year, the use of DES in standard clinical practice on patients did not involve any excess risk of death

A new study by researchers at Rhode Island hospital has found that Drug-eluting Stents (DEK) are as safe and effective as traditional bare-metal stents (BMS) when used in routine clinical practice. These findings were published in the November issue of the Journal of the American College of Cardiology.

In the journal, lead researcher J Dawn Abbott, a cardiologist at Rhode Island Hospital and also an assistant professor of medicine at the Warren Alpert Medical School of Brown University, says that considering that DES are being used in the vast majority of stent procedures, its reassuring to find that they yield better outcomes than BMS in routine clinical practice.

This analysis compared 1,460 patients enrolled in the NHLBI Dynamic Registry in 2004 who received at least one DESK and 1,760 patients who enrolled just before the approval of DES (2001 to 2002) and received at least one bare-metal stent. The study included DES that released either sirolimus or paclitaxel.

The cumulative death and heart attack rate in patients receiving DES was 7.6 per cent to that of 8.7 per cent in those treated with BMS. Also, in patients treated with DES, there was a substantial reduction in clinically-driven target vessel revascularisation (repeat angioplasty or bypass surgery of the target vessel) compared with patients who received bare-metal stents (5 per cent vs 8.7 per cent). Moreover, DES also resulted in enhanced durability of the initial angioplasty.

Back in India also, cardiologists share the same view. They voice the unanimous opinion that DES definitely rules the roost. Says Dr Praveen Chandra, Senior Consultant and Director, Cardiac Cath Lab and Acute MI Services, Max Devaki Devi Heart and Vascular Institute, New Delhi, "Prior to this report, DES were considered to be dangerous because experts were wary about the formation of blocks inside these stent. This report uproots that doubt." Dr Chandra, in fact, prefers to use DES rather than its traditional counterpart. "DES is better when the blockage is longer and there are lesser chances of a reblockage," he adds.

Agrees Dr Mathew Samuel Kalarickal, Director, Interventional Cardiology and Cardiac Catheterisation Laboratories, Apollo Hospitals, Chennai, "It is the truth. People did not look at the long-term benefits of DES. BMS has a 20-30 per cent chance of a recurrence of a blockage while using a DESK has a 0.6 per cent chance which is very minor. So, obviously I would any day go for a DESK." Dr Zakia Khan, Interventional Cardiologist, Wockhardt Hospitals, Mumbai, says, "DES, if used safely, is the best choice."

EH News Bureau