| Journalists:
please note that all presentations are embargoed until the
time of their actual presentation at the Late-Breaking Clinical
Trial (LBCT) sessions or ACC press conference, whichever comes
first. The date and time of each official presentation at
an LBCT session is provided at the end of each trial topic
description.
Highlights
from: Breakthroughs in Coronary Stenting
SUNDAY,
MARCH 6, 2005
12:00
p.m.-1:00 p.m.
Drug-coated
stents continue to win good reviews
(ORLANDO, Fla.)—Stents that prevent re-narrowing
of diseased coronary arteries by slowly releasing powerful
drugs into the artery wall are proving beneficial in a wide
range of patients and for long periods of time, according
to studies being presented at the American College of Cardiology’s
54th Annual Scientific Session in Orlando, Fla., March 6-9,
2005.
In patients whose diseased arteries re-narrow
with scar tissue after an initially successful stenting procedure,
implantation of a second, drug-coated stent is more effective
than radiation therapy, a new study has found (Rainer Hoffmann,
#857-5). All patients in the study had in-stent restenosis
(ISR), a build-up of scar tissue that interferes with blood
flow to the heart through a previously stented artery.
Researchers treated half of patients with the
only proven treatment for ISR—radiation delivered by
a special catheter threaded into the artery. The remaining
patients were treated with a stent that slowly releases, or
“elutes,” sirolimus, a drug that prevents the
growth of scar tissue. At follow-up, the arteries treated
with a drug-coated stent had significantly less repeat re-narrowing
when compared to those treated with radiation. (Original presentation
on Tuesday, March 8, at 4:30 p.m.)
In the first study of its kind, absorbable
metal stents showed promise for the treatment of coronary
artery disease (Raimund Erbel, #1058-1/1). After experiencing
success in treating arteries below the knee, researchers implanted
the novel stents in patients with new blockages in the arteries
in the heart. The stents worked as expected, providing scaffolding
to keep the diseased coronary artery open while being slowly
absorbed into the
arterial wall. (Original presentation on Monday, March 7,
at a 12:30-1:30 p.m. poster session.)
Treatment with a drug-coated stent appears
to offer better clinical results than coronary artery bypass
graft (CABG) surgery in patients with severe heart disease
(Patrick W. Serruys, #1058-6/6). The findings from the second
Arterial Revascularization Therapies Study (ARTS II) counter
those of the first ARTS study, which involved the use of bare-metal
stents and gave the clinical edge to CABG. The new study focused
on patients with a build-up of atherosclerotic plaque in several
coronary arteries who were treated with stents that slowly
release sirolimus, a drug that prevents the build-up of scar
tissue inside the artery. This group was compared to similar
patients treated with CABG in the first ARTS study. Researchers
found that one-month clinical results were better with the
drug-coated stent. (Original presentation on Monday, March
7, at a 12:30-1:30 p.m. poster session.)
The clinical benefits of drug-coated stents
are still apparent years after implantation, according to
two new studies. In the TAXUS-IV study, patients with a single
area of narrowing in a coronary artery were randomly assigned
to treatment with a bare-metal stent or a stent that slowly
releases paclitaxel, a drug that, like sirolimus, prevents
the growth of scar tissue inside the artery (Stephen Ellis,
#807-3). After two years, the rate of major cardiovascular
complications, including death and heart attack, was significantly
lower in patients treated with the drug-coated stent, as was
the need for a repeat procedure to re-establish blood flow
through the diseased artery. (Original presentation on Monday,
March 7, at 11:00 a.m.)
A separate study randomly assigned a
similar group of patients to treatment with a bare-metal stent
or a sirolimus-coated stent (Martin B. Leon, #807-4). After
one and two years of follow-up, the rates of major cardiovascular
complications and repeat coronary procedures were significantly
lower in patients treated with the sirolimus-coated stent.
The researchers will report the findings of a third year of
follow-up at the ACC Annual Scientific Session in Orlando.
(Original presentation on Monday, March 7, at 11:15 a.m.)
Moderator: TBD |
