Newer, next-gen drug eluting stents may not have as large an advantage over contemporary bare metal stents as would be expected, according to findings from the largest stent trial to date.
Data from NorStent, which was published in the New England Journal, indicated that after 6 years, there was no significant difference between patients who received a DES or BMS in terms of rate of total mortality or nonfatal myocardial infarctions.
“Patients treated with DES do not live longer and they do not live better than patients treated with BMS. Although ESC guidelines recommend new DES over BMS as default for coronary revascularization, this recommendation may need to be modified in light of the NorStent findings. Both stent types may be recommended,” Dr. Kaare Bonaa said in a press release.
The 2 arms of the study also showed no significant difference in terms of unstable angina or quality of life, according to the study.
“As expected, the need for repeat revascularization was lowered by DES, but this effect was less than anticipated. The 6 year cumulative rate of repeat revascularization was 16.5 % in the DES group vs. 19.8 % in the BMS group – an absolute risk reduction of 3.3 %. On the basis of this analysis, 30 patients would need to be treated with new DES in order to prevent one repeat revascularization, as compared with contemporary BMS. This figure is 2-fold higher than previously reported,” Dr. Bonaa said in a prepared statement.