XML Feed for RxPG News   Add RxPG News Headlines to My Yahoo!   Javascript Syndication for RxPG News

Research Health World General
 
  Home
 
 Latest Research
 Cancer
 Psychiatry
 Genetics
 Surgery
 Aging
 Ophthalmology
 Gynaecology
 Neurosciences
 Pharmacology
 Cardiology
  Hypertension
  CAD
  Myocardial Infarction
  CHF
  Clinical Trials
 Obstetrics
 Infectious Diseases
 Respiratory Medicine
 Pathology
 Endocrinology
 Immunology
 Nephrology
 Gastroenterology
 Biotechnology
 Radiology
 Dermatology
 Microbiology
 Haematology
 Dental
 ENT
 Environment
 Embryology
 Orthopedics
 Metabolism
 Anaethesia
 Paediatrics
 Public Health
 Urology
 Musculoskeletal
 Clinical Trials
 Physiology
 Biochemistry
 Cytology
 Traumatology
 Rheumatology
 
 Medical News
 Health
 Opinion
 Healthcare
 Professionals
 Launch
 Awards & Prizes
 
 Careers
 Medical
 Nursing
 Dental
 
 Special Topics
 Euthanasia
 Ethics
 Evolution
 Odd Medical News
 Feature
 
 World News
 Tsunami
 Epidemics
 Climate
 Business
Search

Last Updated: Nov 17th, 2006 - 22:35:04

Myocardial Infarction Channel
subscribe to Myocardial Infarction newsletter

Latest Research : Cardiology : Myocardial Infarction

   DISCUSS   |   EMAIL   |   PRINT
Drug-Eluting Stents Effective in Acute Myocardial Infarction: STRATEGY trial
May 4, 2005, 17:42, Reviewed by: Dr.

"In conclusion, our study provides proof of concept for a new treatment strategy in STEMI that incorporates unrestricted use of sirolimus-eluting stenting but results in no (European market) or only a modest (U.S. market) increase in medical expenditure"

 
A type of coronary artery stent that releases a medication appears to result in better outcomes than traditional stents for heart attack patients, according to a study in the May 4 issue of JAMA.

Sirolimus, a substance that is thought to help prevent reclosure of coronary arteries, can be released from certain types of stents (metal devices inserted to keep a coronary artery open after angioplasty) to greatly reduce the need for target-vessel revascularization (TVR) compared with bare-metal stents (i.e., stents without medication), according to background information in the article. These drug-eluting stents have the potential to further improve long-term clinical outcome after primary percutaneous coronary intervention (PCI), such as angioplasty. However, the lack of randomized trials to assess the safety and long-term efficacy of sirolimus-eluting stent implantation in patients with acute ST-segment elevation (a certain measurement on an electrocardiogram) myocardial infarction (STEMI), in conjunction with the expected financial consequences, currently limit use of sirolimus-eluting stents in this setting. Current clinical guidelines specifically recommend the drug abciximab during primary PCI. At current European list prices, the use of the drug tirofiban instead of abciximab would absorb the difference in cost between stenting with sirolimus-eluting vs. bare-metal stents.

Marco Valgimigli, M.D., of the University of Ferrara, Italy and colleagues compared angiographic and clinical outcomes for the treatments of high-dose tirofiban plus sirolimus-eluting stenting vs. a current preferred strategy for STEMI treatment, pretreatment with abciximab plus bare-metal stenting. The STRATEGY trial included 175 patients presenting to a single referral center in Italy with STEMI or presumed new left bundle-branch block between March 6, 2003 and April 23, 2004. Patients received either tirofiban regimen plus sirolimus-eluting stenting (n = 87) or abciximab plus bare-metal stenting (n = 88).

The researchers found that 14 of 74 patients (19 percent) in the tirofiban plus sirolimus-eluting stent group and 37 of 74 patients (50 percent) in the abciximab plus bare-metal stent group reached the primary end point (death, nonfatal heart attack, stroke, or binary restenosis [narrowing of artery] at 8 months). The cumulative incidence of death, reinfarction, stroke, or TVR was significantly lower in the tirofiban plus sirolimus-eluting stent group (18 percent) vs. the abciximab plus bare-metal stent group (32 percent), predominantly reflecting a reduction in the need for TVR. Binary restenosis was present in 6 of 67 (9 percent) and 24 of 66 (36 percent) patients in the tirofiban plus sirolimus-eluting stent and abciximab plus bare-metal stent groups, respectively.

"In conclusion, our study provides proof of concept for a new treatment strategy in STEMI that incorporates unrestricted use of sirolimus-eluting stenting but results in no (European market) or only a modest (U.S. market) increase in medical expenditure," the authors write.
 

- JAMA. 2005;293:2109-2117
 

www.jamamedia.org

 
Subscribe to Myocardial Infarction Newsletter
E-mail Address:

 

For funding/support and financial disclosure information, please see the JAMA article

In an accompanying editorial, Mauricio G. Cohen, M.D., and E. Magnus Ohman, M.D., of the University of North Carolina, Chapel Hill, discuss the findings of the STRATEGY trial.

" the STRATEGY trial is an important step in exploring the use of drug-eluting stents in the setting of AMI. The data suggesting that the use of drug-eluting stents in AMI may be superior to the traditional bare-metal stent approach are encouraging. However, the focus should now shift to the long-term prevention of thrombotic complications through appropriate long-term antiplatelet therapies. It is remarkable to see how STEMI management has evolved over the last decade. With use of increasingly sophisticated stent technology, patients with STEMI are now enjoying substantial benefit by virtue of improved reperfusion with primary PCI, fewer ischemic complications, and lower rates of long-term restenosis. A goal that seemed very distant only a decade ago appears now to have been achieved," the authors write.

JAMA. 2005;293:2154-2156


Related Myocardial Infarction News

Few athletes survive sudden cardiac arrest (SCA)
PlGF involved in Post Myocardial Infarction Healing Process
The key elements for success in the rapid treatment of heart attacks
Daily cocoa intake can save you from heart attack
Heartbreaks can trigger heart attacks in the healthy
Chronic noise exposure increase risk of heart attacks
Sweat is good indicator of impending heart attack
Darbepoietin offers significant protection to heart tissue from injury due to ischemia
Waist-to-hip ratio determines risk of a heart attack
Ambient air pollution linked with acute myocardial infarction


For any corrections of factual information, to contact the editors or to send any medical news or health news press releases, use feedback form

Top of Page

 

© Copyright 2004 onwards by RxPG Medical Solutions Private Limited
Contact Us