Newest Coated Stent Does Well in Real-World Trial

Safe and effective in an 'all-comer population,' researchers say

By Ed Edelson
HealthDay Reporter

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WEDNESDAY, June 17 (HealthDay News) -- The newest drug-coated stent has performed well in a real-life trial, Dutch cardiologists report.

The Xience stent -- a flexible metal-mesh tube coated with the drug everolimus -- is inserted to keep blood flowing after artery-opening procedures such as angioplasty, and is already in widespread use. It was approved by the U.S. Food and Drug Administration last July, on the basis of good results in controlled trials.

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But those trials included only people with simple artery blockages and the effectiveness of the new stent in "complex, unselected patients treated in daily practice still remains unknown and cannot be extrapolated from these randomized controlled trials," said cardiologists at Erasmus Medical Center in Rotterdam in their report, which was released online June 17 in advance of publication in the Journal of the American College of Cardiology. "We therefore sought to evaluate the impact of this second-generation drug-eluting stent on the clinical outcomes in consecutive patients treated in a real-life, all-comer population."

The trial compared the outcomes of 649 people given Xience stents with individuals who previously had stents implanted -- 450 with bare-metal stents, 508 with stents coated with the drug sirolimus and 576 with stents coated with the drug paclitaxel. The data include people with multiple artery blockages and some treated after heart attacks.

In the cautious phrasing of the Rotterdam group, "this study suggests that the use of everolimus-eluting stents in an unselected population may be as safe as and more effective than bare-metal stents, may be as safe and effective as sirolimus-eluting stents, may be as safe as paclitaxel-eluting stents, and may be more effective than paclitaxel-eluting stents."

Specifically, in a six-month follow-up period, the incidence of death, heart attack and stenosis (new blockage of the artery) was lower for the Xience group than for those with bare-metal stents and slightly better than those with first-generation drug-eluting stents.

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