Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:


New 'real-world' reassuring data from the SCAAR registry

New generation drug-eluting stents associated with lower rates of mortality and restenosis than bare metal stents

A registry -which includes every patient in Sweden having percutaneous coronary intervention (PCI) for the treatment of acute and stable coronary artery disease- has found that PCI implantations using a new generation of drug-eluting stents is associated with lower rates of relapse (restenosis), stent thrombosis and subsequent mortality than older generation drug-eluting stents and bare-metal stents.(1)

The findings, from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR), reported in the European Heart Journal, represent the outcome of treatment in a large "real-world population", and were derived from an analysis of 94,384 consecutive stent implantations performed in Sweden between November 2006 and October 2010.

An earlier study from the SCAAR registry, evaluating stent implantations between 2003 and 2004, had dramatically shown that those treated with drug-eluting stents (DES) had a higher rate of later mortality than those receiving bare-metal stents (BMS).(2) The results caused uproar, and prompted an immediate decline in the use of DES and an urgent review of their safety. However, follow-up of the same patient cohort two years later (with data extended to 2006) found no increased risk of death between the two groups.(3) The difference in outcome was largely explained by improvements in cardiology practice (including the application of dual antiplatelet therapy after PCI) and the introduction of improved devices.

Conclusions in this latest report, from what is the world's largest PCI registry with the longest follow-up of data, now confirm that mortality rates associated with both the new and old generations of DES were significantly lower than found with BMS. The risk of death was 28% lower with the old generation DES and 45% lower with the new generation; moreover, the new generation DES were associated with a 23% lower mortality rate at two years than the old generation DES.

The authors note that this is the first time any mortality reduction has been shown between DES and BMS, either in randomised trials or in reports from the SCAAR registry itself.

The study also found that the new generation of DES was associated with a 38% lower risk of restenosis and a 43% lower risk of stent thrombosis within two years of implantation than BMS. Late stent thrombosis has been a recurring safety concern with the original DES; the authors suggest that the new generation DES, with "thin, more biocompatible polymers" and greater flexibility, may have contributed to lowering this thrombotic risk.

Speaking on behalf of the SCAAR investigators, cardiologist Dr Stefan James from Uppsala University Hospital in Sweden described the latest findings as "intriguing" - not just because of the lower rates of restenosis with the latest generation of DES, which were expected, but also of stent thrombosis and mortality. "The low rates of restenosis and stent thrombosis correspond with the results of several recent randomised trials," said Dr James, "and this may well translate into mortality reduction in a sufficiently large study population."

However, he warned that all observational data should be interpreted with caution. "Despite the use of appropriate statistical methods," he said, "there may be residual confounding because of differences in concealed baseline variables." Nevertheless, this SCAAR analysis included only patients who where treated after 2006, to ensure that both the older and newer generation DES were used. "Since 2006 no major changes in recommendations for antithrombotic strategies or duration of dual antiplatelet therapy have occurred in Sweden," said Dr James, "so it seems likely that our more favourable outcomes are true findings."

The investigators say their results now add further weight to the strong recommendation for the use of DES as a default strategy in patients expected to tolerate extended dual antiplatelet therapy, in the treatment of coronary artery disease. "But our results also reinforce the need for randomised trials to evaluate the optimal strategy and duration of antithrombotic therapy following PCI in various indications," said Dr James.

Notes for editors

1. Sarno G, Lagerqvist B, Frober O, et al. Lower risk of stent thrombosis and restenosis with unrestricted use of 'new-generation' drug-eluting stents: a report from the nationwide Swedish Coronary Angiography and Angioplasty Registry (SCAAR). Eur Heart J 2012; doi:10.1093/eurheartj/ehr479

2. Lagerqvist B, James SK, Stenestrand U, et al. Long-term outcomes with drug-eluting stents versus bare-metal stents in Sweden. N Engl J Med 2007; 356: 1009-1019.

3. James SK, Stenestrand U, Lindback J, et al. Long-term safety and efficacy of drug-eluting versus bare-metal stents in Sweden. N Engl J Med 2009; 360: 1933-1945.

* Drug-eluting stents are metallic mesh tubes which keep open narrowed coronary arteries while slowly releasing a medication to prevent the build-up of scar tissue inside the stent.

* The European Heart Journal is a journal of the European Society of Cardiology.

* More information on this press release, interview contacts and a PDF of the paper is available from the ESC's press office:

ESC Press Office | EurekAlert!
Further information:

More articles from Health and Medicine:

nachricht Resolving the mystery of preeclampsia
21.10.2016 | Universitätsklinikum Magdeburg

nachricht New potential cancer treatment using microwaves to target deep tumors
12.10.2016 | University of Texas at Arlington

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: New 3-D wiring technique brings scalable quantum computers closer to reality

Researchers from the Institute for Quantum Computing (IQC) at the University of Waterloo led the development of a new extensible wiring technique capable of controlling superconducting quantum bits, representing a significant step towards to the realization of a scalable quantum computer.

"The quantum socket is a wiring method that uses three-dimensional wires based on spring-loaded pins to address individual qubits," said Jeremy Béjanin, a PhD...

Im Focus: Scientists develop a semiconductor nanocomposite material that moves in response to light

In a paper in Scientific Reports, a research team at Worcester Polytechnic Institute describes a novel light-activated phenomenon that could become the basis for applications as diverse as microscopic robotic grippers and more efficient solar cells.

A research team at Worcester Polytechnic Institute (WPI) has developed a revolutionary, light-activated semiconductor nanocomposite material that can be used...

Im Focus: Diamonds aren't forever: Sandia, Harvard team create first quantum computer bridge

By forcefully embedding two silicon atoms in a diamond matrix, Sandia researchers have demonstrated for the first time on a single chip all the components needed to create a quantum bridge to link quantum computers together.

"People have already built small quantum computers," says Sandia researcher Ryan Camacho. "Maybe the first useful one won't be a single giant quantum computer...

Im Focus: New Products - Highlights of COMPAMED 2016

COMPAMED has become the leading international marketplace for suppliers of medical manufacturing. The trade fair, which takes place every November and is co-located to MEDICA in Dusseldorf, has been steadily growing over the past years and shows that medical technology remains a rapidly growing market.

In 2016, the joint pavilion by the IVAM Microtechnology Network, the Product Market “High-tech for Medical Devices”, will be located in Hall 8a again and will...

Im Focus: Ultra-thin ferroelectric material for next-generation electronics

'Ferroelectric' materials can switch between different states of electrical polarization in response to an external electric field. This flexibility means they show promise for many applications, for example in electronic devices and computer memory. Current ferroelectric materials are highly valued for their thermal and chemical stability and rapid electro-mechanical responses, but creating a material that is scalable down to the tiny sizes needed for technologies like silicon-based semiconductors (Si-based CMOS) has proven challenging.

Now, Hiroshi Funakubo and co-workers at the Tokyo Institute of Technology, in collaboration with researchers across Japan, have conducted experiments to...

All Focus news of the innovation-report >>>



Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

Agricultural Trade Developments and Potentials in Central Asia and the South Caucasus

14.10.2016 | Event News

World Health Summit – Day Three: A Call to Action

12.10.2016 | Event News

Latest News

Resolving the mystery of preeclampsia

21.10.2016 | Health and Medicine

Stanford researchers create new special-purpose computer that may someday save us billions

21.10.2016 | Information Technology

From ancient fossils to future cars

21.10.2016 | Materials Sciences

More VideoLinks >>>