Stents Fail A Big Test
1 CommentBy Ed Silverman // March 26th, 2007 // 12:47 pm
A closely watched study of 2,300 patients found that the wire mesh tubes failed to prevent heart attacks or deaths. Researchers compared angina patents who were treated with angioplasty and heart drugs with another group who received meds, but not procedures.
This shouldn’t come as a surprise because stents have never been proven to reduce deaths. Still, cardiologists have been waiting for more definitive data and, most likely, will not be encouraged to rely more on stents, given the outcome.
“The results demonstrate that two treatments are not always better than one,” says Bill Boden, chief of cardiology at Buffalo General Hospital, who led the Department of Veterans’ Affairs-sponsored study, which was reported today at the American College of Cardiology meeting in New Orleans.
The study is also available today in the New England Journal of Medicine, in which an accompanying editorial was unequivocal: Using stents “has an established place in treating angina but is not superior to intensive medical therapy to prevent myocardial infarction and death in symptomatic and asymptomatic patients,” wrote Judith Hochman, a cardiologist at the New York University School of Medicine, and P. Gabriel Steg, a cardiologist at Centre Hospitalier Bichat in Paris.
Not surprisingly, investors reacted by sending shares in Boston Scientific, a big and troubled stent maker, plunging. Conversely, shares in Abbott Labs, which over the weekend reported promising stent results, were soaring today. Says Larry Biegelsen of Prudential Equity in an investor note today: “We think the will have a modest negative impact on stent procedures because stents provide some symptom benefit and there are financial incentives for stenting.”
The study abstract;
The study press release;
New England Journal of Medicine editorial (subscription may be required);
Story in The Wall Street Journal (subscription required);
Story from Reuters.
[tags]Abbott Laboratories, Boston Scientific, Johnson & Johnson[/tags]
Bruce Grant
“…not superior to intensive medical treatment.”
Unless you consider a life in which walking to the corner without disabling chest pain requires taking a nitroglycerin tablet before setting out, then stopping halfway to take another — and in which the side effects of the intensive medical (i.e., drug) treatment can include sleep disturbances, fatigue, mental confusion, and impotence — to be no different from a pain-free life of relatively normal function, following an invasive revascularization procedure, like bypass surgery or angioplasty.
The cardiologists who treat patients with coronary disease day in and day out seem to think, however, that there is a very big difference between those two lives — and are grateful that we now have effective treatments that can restore these patients to a near-normal life, even if those lives are not a minute longer than they would have been without the procedures.