Premature excitement
Don’t be too amused by recent reports of a “small but significant” increase in thrombosis with drug eluting stents nor expect a windfall of patients queuing up, returning to the joyous cries of cardiac surgeons slapping themselves on the back singing “I told you so!”.
While monitoring for complications, the FDA states that it still currently “believes that coronary drug-eluting stents remain safe and effective when used for the FDA-approved indications”. Furthermore, the meta-analysis by Camenzind (presented to the 2006 European Society of Cardiology Annual Meeting) reported death and Q-wave MI increased in drug-eluting to bare-metal stents. The conclusions imply selective return to bare metal stents as opposed to a mass exodus towards coronary artery surgery.
As a group, we naturally extol what we like to hear and ignore what we don’t. Before peering over the fence at our neighbor’s gardens, maybe we should look at the results off pump graft patency. This month (December 2006) in the Journal of Thoracic and Cardiovascular Surgery, we reported a significant increase in graft occlusion in randomised trials of off pump compared to conventional surgery, but maybe you don’t really want to hear about that…