Heart Patients Seek Guidance on Stents, Statins

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Drugs such as aspirin, statins, beta blockers and ACE inhibitors ease the inflammation and cholesterol build-up that causes cardiovascular disease to begin with, the experts said.

"The key to remember here is that every patient needs medical therapy," Gibbons said, "because angioplasty only treats the area of the artery with the severe blockage. If people find a physician who does not seem to believe in optimal medical therapy, then they should find another physician."

Other studies at the meeting highlighted the potential pitfalls of drug-coated stents, which can cost upwards of $2,000 each. Medications embedded in the devices keep artery re-closure at bay, but the use of these devices has also been linked to the occasional development of large clots. For that reason, patients are advised to take blood-thinners such as aspirin and clopidogrel (Plavix) for at least one year after stent placement.

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However, two studies found that some stented patients don't respond to Plavix (raising their clot risk), and about 30 percent of patients fail to take the medications as prescribed.

So, are drug-coated stents appropriate for everyone in serious danger of heart attack or stroke? Certainly not, the experts said.

Because patients must take blood-thinning aspirin and Plavix, "if the patient has increased bleeding risks, then drug-eluting stents are not for them," Gibbons said. "For patients needing non-cardiac surgery within the next 12 months, drug-eluting stents are not a good option. And if patient's resources are such that they are unlikely to be able to afford clopidogrel for the next year, drug-eluting stents are not for them."

Otherwise, the advantage of a drug-coated stent is assessed by doctors on a case-by-case basis, Gibbons said. "The advantage often depends on the size of the blood vessel and individual patient characteristics," he explained.

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