2 Studies Find Drug-Eluting Stents Risky Without Blood Thinner

Heart patients with such stents face higher sudden-death risk, cardiologists report.

By Ed Edelson
HealthDay Reporter

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TUESDAY, Dec. 5 (HealthDay News) -- Heart patients with drug-eluting stents implanted to keep their arteries open have a higher risk of sudden death than those getting bare-metal stents if they stop taking the blood-thinning drug Plavix, Swiss and American cardiologists report.

The reports were both released early to coincide with a U.S. Food and Drug Administration advisory panel meeting this week on the safety of drug-eluting stents.

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There has been growing concern about the long-term safety of drug-eluting stents, which hold 80 percent or more of the American market. Both studies link the danger of heart attack or sudden death to discontinuation of Plavix (clopidogrel), a drug commonly prescribed for patients who have stents implanted after the artery-opening procedure called angioplasty.

The Swiss study of 746 people who had 1,113 stents implanted did show that the drug-eluting stents did a better job of keeping arteries open. But the incidence of death or heart attack for those patients was 4.9 percent, compared to 1.9 percent for patients with bare-metal stents. The reason was a higher incidence of thrombosis, which is sudden blockage of an artery by a blood clot. The findings were published in the Dec. 19 issue of the Journal of the American College of Cardiology.

The U.S. study of more than 4,600 patients, done by Duke University researchers, found similar results. Patients with drug-eluting stents who stopped taking Plavix had more than twice the risk of death or heart attack than those who continued to take the drug, according to the report in the Dec. 6 issue of the Journal of the American Medical Association.

"The overall risk over the pursuing 18 months was 7.2 percent versus 3.1 percent," said Dr. David F. Kong, assistant professor of medicine at Duke, and a member of the research team. "We also looked at bare-metal stents. The risk of death or heart attack was about 6 percent for those not taking Plavix, 5.5 percent for those taking Plavix.

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