Drug-coated cardiac stents are not supported by evidence

Release date: 2006-11-07

Drug-Coated Cardiac Stent Diseases Lack of Evidence Support Recently, it has been reported that the use of drug-coated cardiac stents in the treatment of heart disease can increase patient mortality more than with normal cardiac stents. This has caused strong repercussions in the medical community and has caused panic among many heart patients.
In this regard, the Vice President of the Chinese Medical Doctor Association and the Chairman of the Chinese Medical Association Cardiovascular Branch, Dr. Gao Runlin, pointed out at the 17th Great Wall International Cardiology Conference held on the 3rd that the drug-coated cardiac stent is safe and effective. There is no evidence that it increases patient mortality more than normal cardiac stents.
Drug-eluting stents have long been considered a revolution in “interventional therapy” for coronary heart disease because the drug rapamycin in the coating is released continuously and steadily, solving the recurrence of blood vessels that often occur after placement of bare stents. problem.
However, at the 2006 World Congress of Cardiology in Barcelona, ​​Spain, in September this year, two Swiss experts put forward a surprising point: drug-coated stents widely used in heart disease treatment, compared with bare metal stents, death, The risk of myocardial infarction and stent thrombosis is higher.
Experts from the field of cardiovascular disease research in China, Dr. Gao Runlin from Beijing Foreign Hospital, Professor Ma Changsheng from Beijing Anzhen Hospital, and Zhao Yiwei, general manager of Johnson & Johnson (China) Cordis, responded to this view on the 3rd.
According to reports, the International Conference on Cardiac Interventions held in the United States last week held a panel discussion on the views of two Swiss experts. The data on which the conclusions are based are derived from the literature archives rather than the original cases, in terms of statistics, analysis and definition. There are problems, and there are too few non-cardiac death studies, and the sampling error is too large.
A secondary analysis of the conference showed that drug-eluting stents did not increase the mortality of heart disease patients compared to bare metal stents; there was no increased risk of thrombosis within one year of use; despite the risk of thrombosis after one year of use An increase of 0.2% per year, but still has not led to an increase in mortality.
Gao Runlin pointed out that from the current research results, drug-coated stents will not increase the mortality rate of heart disease and the risk of myocardial infarction and stent thrombosis, and are safe and effective medical devices. At the same time, drug-eluting stents can reduce the incidence of recurrent stenosis that often occurs after stent placement by 60% to 70%.
Gao Runlin also recommended relevant manufacturers to further improve drug-eluting stents, reduce allergic reactions that may be caused by them, and develop a new generation of stent products as soon as possible; medical personnel should carefully use drug-coated stents for non-cardiac surgery or intolerance in the near future. Do not use drug-coated stents for patients with long-term antiplatelet therapy.
—— Information from: Xinhuanet

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