European Heart Journal Advance Access originally published online on November 15, 2006
European Heart Journal 2006 27(23):2737-2739; doi:10.1093/eurheartj/ehl378
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© The European Society of Cardiology 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Increased mortality after implantation of first generation drug-eluting stents: seeing the smoke, where is the fire?
1 Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium
2 Duke University Medical Center, CV Devices Unit Director, Duke Clinical Research Institute, Durham, NC, USA
* Corresponding author. Tel: +32 53 72 44 39; fax: +32 53 72 41 85. E-mail address: william.wijns@olvz-aalst.be
This editorial refers to ‘Mortality in randomized controlled trials comparing drug-eluting vs. bare metal stents in coronary artery disease: a meta-analysis’
by A.J. Nordmann et al., on page 2784 and ‘Cause of death with bare metal and sirolimus-eluting stents’; by D.R. Holmes et al., on page 2815
| The first 150 words of the full text of this article appear below. |
Background
During the World Congress of Cardiology 2006 in Barcelona, concerns regarding the long-term safety of drug-eluting stents (DES) have been voiced based on meta-analyses including numbers large enough to relate statistical significance to low incidence events such as late-stent thrombosis and mortality in percutaneous coronary intervention (PCI) patients. Since then, these potential safety issues have commanded widespread attention from the medical community, health care providers, regulatory bodies, the press, and the public.
Interpretation of compiled data sets, formally as meta-analyses or pooled with any statistical methods, is fraught with complexities, in particular in trying to understand relevance to daily clinical practice. Across variations in study inclusion criteria, adjunctive therapies and endpoint definitions, DES studies are notable for such complexity. Nonetheless, it is essential that large and relevant data are published and the two analyses of mortality outcome in patients receiving DES reported back-to-back in this issue of the Journal bear
Executive summary of the meta-analysis by Nordmann
Commentary
Executive summary of the study by Holmes
Commentary
Comparison between studies
Take home message for the clinician
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Related articles in EHJ:
- Mortality in randomized controlled trials comparing drug-eluting vs. bare metal stents in coronary artery disease: a meta-analysis
- Alain Joel Nordmann, Matthias Briel, and Heiner Claudins Bucher
EHJ 2006 27: 2784-2814.[Abstract] [Full Text] - Cause of death with bare metal and sirolimus-eluting stents
- David R. Holmes, Jr, Jeffrey W. Moses, Joachim Schofer, Marie-Claude Morice, Erick Schampaert, and Martin B. Leon
EHJ 2006 27: 2815-2822.[Abstract] [Full Text]
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