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BOSTON — Drug-eluting stents worked no better than bare-metal stents for preventing restenosis in heart transplant patients in a review of 80 stents placed at one U.S. center.
“In [heart transplant] patients with focal lesions, we saw no advantage to using drug-eluting stents, compared with bare-metal stents,” Dr. Proddutur R. Reddy said at the annual meeting of the International Society for Heart and Lung Transplantation.
Speculating why the sirolimus-eluting coronary stents used at his center did not perform as usual and cut restenosis, compared with bare-metal stents, Dr. Reddy suggested that the systemic immunosuppressive treatment received by all of the transplant patients might reduce systemic inflammation and thereby diminish the risk of in-stent restenosis regardless of the stent type used.
The review also found no differences in survival or the incidence of major adverse coronary events during 1 year of follow-up, but because of the small number of patients, it would not be expected to show any differences in clinical outcomes.
Since 1999, 42 patients who had received a heart transplant at Loyola University Medical Center in Maywood, Ill., subsequently underwent a percutaneous coronary intervention with one or more stents for treatment of focal stenoses. The series included placement of 56 sirolimus-eluting stents and 24 bare-metal stents, said Dr. Reddy, a cardiologist at the medical center. There were no significant differences in the demographic or clinical characteristics of patients getting the two different stent types, although a larger percentage of the patients getting bare-metal stents had diabetes, compared with those who received drug-eluting stents. A larger percentage of patients who received drug-eluting stents had more complex coronary lesions, and the average coronary diameter in the drug-eluting stent group was smaller.
A year after stent placement, the rate of binary restenosis (50% stenosis or greater) was 23% in both subgroups.
The study did not have commercial support, and Dr. Reddy said that he did not have any financial disclosures relative to the study.
BOSTON — Drug-eluting stents worked no better than bare-metal stents for preventing restenosis in heart transplant patients in a review of 80 stents placed at one U.S. center.
“In [heart transplant] patients with focal lesions, we saw no advantage to using drug-eluting stents, compared with bare-metal stents,” Dr. Proddutur R. Reddy said at the annual meeting of the International Society for Heart and Lung Transplantation.
Speculating why the sirolimus-eluting coronary stents used at his center did not perform as usual and cut restenosis, compared with bare-metal stents, Dr. Reddy suggested that the systemic immunosuppressive treatment received by all of the transplant patients might reduce systemic inflammation and thereby diminish the risk of in-stent restenosis regardless of the stent type used.
The review also found no differences in survival or the incidence of major adverse coronary events during 1 year of follow-up, but because of the small number of patients, it would not be expected to show any differences in clinical outcomes.
Since 1999, 42 patients who had received a heart transplant at Loyola University Medical Center in Maywood, Ill., subsequently underwent a percutaneous coronary intervention with one or more stents for treatment of focal stenoses. The series included placement of 56 sirolimus-eluting stents and 24 bare-metal stents, said Dr. Reddy, a cardiologist at the medical center. There were no significant differences in the demographic or clinical characteristics of patients getting the two different stent types, although a larger percentage of the patients getting bare-metal stents had diabetes, compared with those who received drug-eluting stents. A larger percentage of patients who received drug-eluting stents had more complex coronary lesions, and the average coronary diameter in the drug-eluting stent group was smaller.
A year after stent placement, the rate of binary restenosis (50% stenosis or greater) was 23% in both subgroups.
The study did not have commercial support, and Dr. Reddy said that he did not have any financial disclosures relative to the study.
BOSTON — Drug-eluting stents worked no better than bare-metal stents for preventing restenosis in heart transplant patients in a review of 80 stents placed at one U.S. center.
“In [heart transplant] patients with focal lesions, we saw no advantage to using drug-eluting stents, compared with bare-metal stents,” Dr. Proddutur R. Reddy said at the annual meeting of the International Society for Heart and Lung Transplantation.
Speculating why the sirolimus-eluting coronary stents used at his center did not perform as usual and cut restenosis, compared with bare-metal stents, Dr. Reddy suggested that the systemic immunosuppressive treatment received by all of the transplant patients might reduce systemic inflammation and thereby diminish the risk of in-stent restenosis regardless of the stent type used.
The review also found no differences in survival or the incidence of major adverse coronary events during 1 year of follow-up, but because of the small number of patients, it would not be expected to show any differences in clinical outcomes.
Since 1999, 42 patients who had received a heart transplant at Loyola University Medical Center in Maywood, Ill., subsequently underwent a percutaneous coronary intervention with one or more stents for treatment of focal stenoses. The series included placement of 56 sirolimus-eluting stents and 24 bare-metal stents, said Dr. Reddy, a cardiologist at the medical center. There were no significant differences in the demographic or clinical characteristics of patients getting the two different stent types, although a larger percentage of the patients getting bare-metal stents had diabetes, compared with those who received drug-eluting stents. A larger percentage of patients who received drug-eluting stents had more complex coronary lesions, and the average coronary diameter in the drug-eluting stent group was smaller.
A year after stent placement, the rate of binary restenosis (50% stenosis or greater) was 23% in both subgroups.
The study did not have commercial support, and Dr. Reddy said that he did not have any financial disclosures relative to the study.