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SCAAR: no increased mortality with drug-eluting stents
One additional year of follow-up demonstrates better patient outcomes.
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VIENNA, Austria — The results of four years of follow-up from the Swedish Coronary Angiography and Angioplasty Registry no longer indicate any increased mortality in patients treated with drug-eluting stents compared with patients treated with bare metal stents.
Last year’s reported increased risk of death occurred during the initial years after drug-eluting stents approval and release on the market. In patients who have received drug-eluting stents more recently, no increased risk was observed.
Stefan James, MD, PhD, of the Uppsala Clinical Research Center, Sweden, said the updated results from SCAAR indicated that there was an approximate 0.5% annual risk of stent thrombosis with the drug-eluting stents, explaining the slightly higher risk of late MI with these stents. The absolute risk of restenosis at the end of follow-up was reduced by approximately 4% compared with bare metal stents.
National registry
SCAAR records consecutive patients from all centers performing coronary angiography and percutaneous coronary interventions in Sweden. Patients were included in the analysis if they had PCI with a minimum of one-year follow-up. The study had 13,785 patients in Sweden who had undergone implantation with at least one drug-eluting stent compared with 21,477 patients treated with one or more bare metal stents between January 2003 and December 2006.
During the study period, 4,160 MIs occurred and there were 2,957 deaths. There was no difference in the primary endpoint of mortality or MI or mortality alone.
James said possible explanations for the better outcomes in the 2005 drug-eluting stent cohort could be an increased awareness of late stent thrombosis with the possibility that the duration of dual antiplatelet therapy is being prolonged and that the stenting technique with higher balloon pressure and better-sized stents is being practiced. The selection of patients for drug-eluting stents could also have improved, he said. – by Judith Rusk
For more information:
- James S. Long term mortality after drug-eluting stents in Sweden – one additional year of follow-up. Clinical trial update I #1021. Presented at: The European Society of Cardiology Congress; Sept. 1-5, 2007; Vienna, Austria.