MONDAY, July 9 (HealthDay News) — The use of drug-coated stents
to keep arteries open after an artery-clearing procedure varies greatly
among U.S. surgeons, and those who do insert the devices may not need to
in patients at low risk of re-clogged arteries, a new study finds.
The research suggests that surgeons could use the stents somewhat less
frequently, saving the American health care system tens of millions of
dollars while only slightly increasing the number of patients suffering
from re-clogged arteries.
The study was released online July 9 in advance of publication in an
upcoming print issue of the journal Archives of Internal
Medicine.
The finding is related to a specific kind of stent used in
angioplasties, which are procedures designed to clear clogged arteries.
Unlike some stents, which are simply metal, these “drug-eluting” stents
release medications designed to prevent further clogging.
The study was led by Dr. John Spertus, clinical director of Outcomes
Research at Saint Luke’s Mid America Heart Institute in Kansas City. His
team examined the medical records of more than 1.5 million patients who
underwent angioplasties to see what happened to them. The researchers
found that many doctors used the stents regardless of the estimated risk
that the patients’ vessels would re-clog.
The American health care system could save more than $200 million a
year, the researchers estimated, if surgeons used the drug-releasing
stents half as much in patients at low risk of future artery clogging.
This reduction in usage was estimated to increase the rate of re-clogged
arteries by about 0.5 percent, according to the report.
Commenting on the study, Dr. David L. Brown, a cardiologist and
professor of medicine at Stony Brook University, said that the study
findings are valid and reflect “the irrational overuse of new technology.”
“Unfortunately, this study illustrates yet another example of
cardiologists running up the costs of health care rather than leading in
controlling costs without compromising outcomes,” he said. “Hopefully this
paper will stimulate changes in practice by interventional cardiologists.”
As for patients, Brown said they “should understand that many of them
will not benefit from drug-eluting stents. Furthermore, drug-eluting
stents come with a financial cost as well as the risk and additional cost
of prolonged dual antiplatelet therapy. They should discuss the risks and
benefits of drug-eluting stents before any proposed stent procedure.”
More information
For more about angioplasty, visit the U.S. National Library of
Medicine.
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