Heart Disease Home > The Benefits of Drug-Eluting Stents for Women With Coronary Artery Disease
How Does the DES Compare to Previous Stents?
Previous studies have shown that drug-eluting stents have a definite benefit over the bare-metal ones. However, these studies primarily involved men. Could the same conclusions be drawn for women? Studies so far have shown the answer is a definite "yes."
In particular, these studies have shown that over a three-year period, drug-eluting stents (especially the newer, second-generation ones) are safer and more effective than bare-metal stents. When compared to bare-metal stents, drug-eluting stents (including both the older first-generation ones and the new ones) reduced the risk of heart attack and death. Similar to what was seen in previous studies in men, there was a higher risk for clotting at the stent with the older DES, compared with bare-metal stents. However, the newer DES had the lowest clotting risk of all.
In addition, there were lower rates of "target-lesion revascularization" -- basically a repeat of the procedure. The authors of one study concluded that "newer-generation DES are associated with an improved safety profile compared with early-generation DES, and should therefore be thought of as the standard of care for percutaneous coronary revascularization in women."
So does this mean that if you're a woman with heart disease (or maybe you've already had a heart attack), you should definitely opt for a DES over a bare-metal stent or maybe a coronary artery bypass (CABG)? Not necessarily. A recent study showed that CABG has an advantage in particularly serious cardiovascular events. In addition, in women with significant disease, in the long term, there appears to be no difference between the two in terms of rates of heart attack and death.
The bottom line is that the DES offers a safe, effective, beneficial way to treat CAD and prevent associated complications in women with heart disease. Whether it's right for you, however, is something that you will need to discuss and consider carefully with your healthcare provider.
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Stefanini GG, Baber U, Windecker S, et al. Safety and efficacy of drug-eluting stents in women: a patient-level pooled analysis of randomised trials. Lancet 2013 7;382(9908):1879-88.
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