Study Finds Benefits With Drug-Coated Stents

The "big surprise" of the study was the reduction of the death rate with drug-eluting stents, Nissen said. "But the authors appropriately caution that the finding needs confirmation by randomized clinical trials," he said.

"In my view, we've learned all we can from observational trials," Nissen added. "We need a good long-term controlled trial" of stents.

However, Dr. Kirk Garratt, clinical director of interventional cardiovascular research at Lenox Hill Hospital in New York City, said the Canadian trial was no ordinary observational study.

"The best thing about this paper is the technique they used for matching bare-metal stent patients with drug-coated stent patients," Garratt said. "It was easy for me to figure out quickly and easily the impact of having put a drug-coated stent into a patient. It was linked to an important improvement in how patients do over a long period of time."

One reason the coated stents performed so well is that Canada's health-care system automatically provides the clot-preventing drug Plavix, plus aspirin, for all stent recipients. Those drugs are recommended for American recipients, and the federal government recently began to pay for them, Garratt said.

"That is reason to hope that the U.S. population will see these benefits in the next few years," he said.

More information

You can learn why and how stents are used from the U.S. National Heart, Lung, and Blood Institute.

SOURCES: Jack V. Tu, M.D., senior scientist, Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Steven Nissen, M.D., chairman of cardiovascular medicine, Cleveland Clinic; Kirk Garratt, M.D., clinical director of interventional cardiovascular research, Lenox Hill Hospital, New York City; Oct. 4, 2007,New England Journal of Medicine