Drug-Eluting Stents Reduce Risk of Thrombosis
(HealthDay News) – Cobalt-chromium everolimus eluting stents (CoCr-EES) are associated with a significantly lower rate of stent thrombosis within two years of implantation, compared with other bare-metal and drug-eluting stents, according to a meta-analysis published online March 23 in The Lancet.
Tullio Palmerini, MD, from the Policlinico S. Orsola in Bologna, Italy, and colleagues compared the risk of thrombosis between bare-metal and drug-eluting stents in an analysis of 49 trials involving 50,844 patients.
The researchers found that, compared with bare-metal stents, the one-year definite stent thrombosis rate was significantly lower with CoCr-EES (odds ratio [OR], 0.23). This difference was seen as early as 30 days (OR, 0.21) and continued to be significant from 31 days to one year (OR, 0.27). Compared with paclitaxel-eluting stents, permanent polymer-based sirolimus-eluting stents, phosphorylcholine-based zotarolimus-eluting stents, and Resolute zotarolimus-eluting stents, CoCr-EES were associated with significantly lower rates of one-year definite stenosis (ORs, 0.28, 0.41, 0.21, and 0.14, respectively). CoCr-EES correlated with significantly lower rates of definite stent thrombosis compared with bare-metal and paclitaxel-eluting stents after two years of follow-up (OR, 0.35 and 0.34, respectively). At two-year follow-up, no other drug-eluting stent had lower definite thrombosis rates compared with bare-metal stents.
"In randomized studies completed to date, CoCr-EES has the lowest rate of stent thrombosis within two years of implantation. The finding that CoCr-EES also reduced stent thrombosis compared with bare-metal stents, if confirmed in future randomized trials, represents a paradigm shift," the authors write.
Several authors disclosed financial ties to the pharmaceutical, medical device, and biotechnology industries.