Recently, a clinical study was conducted to find out the effectiveness of modern heart stents in patients who had narrowing of blood vessels in the legs in addition to the blood vessels of the heart.
Coronary artery disease (CAD) is the most common type of heart disease in the United States. It is a major cause of death in the United States and worldwide. Coronary artery disease is caused by plaque buildup in the wall of the arteries that supply blood to the heart (called coronary arteries). Plaque is made up of cholesterol deposits. These deposits narrow the lumen of the arteries over time and eventually reduce the blood flow to the heart causing a heart attack. Peripheral arterial disease, on the other hand, is the narrowing or blockage of the vessels that carry blood from the heart to the legs resulting in pain.
Percutaneous coronary intervention (PCI) is a common procedure used to treat blocked or narrowed coronary arteries. It involves the insertion of a stent, a small mesh tube, into the affected artery to keep it open and improve blood flow to the heart. Previously, bare metal and early-generation drug-eluting coronary stents were used in PCI. However, the effectiveness of these old stents was reduced in patients who also had peripheral arterial disease.
In recent years, newer types of stents have been introduced for heart disease. These stents are thought to be superior to the old ones. However, their effectiveness in patients with concomitant peripheral artery disease is yet to be determined.
A recent clinical study published in the Atherosclerosis Journal analyzed the outcomes of percutaneous coronary intervention (PCI) with these modern stents in patients who also had peripheral arterial disease (PAD).
The clinical study was an analysis of four previously conducted clinical trials which involved 9204 patients of which 695 patients had peripheral arterial disease in addition to heart disease. Failure rates of the new stents as well as the risk of death in these patients were calculated.
The results of this clinical study indicated that peripheral arterial disease resulted in an increased risk of stent failure, death, and the need for additional procedures in these patients. The stent failure rate was 16.4% in patients who had concomitant peripheral artery disease in addition to heart disease. On the other hand, the stent failure rate was only 9.4% in those patients who had heart disease alone. The results also showed that the risk of adverse events was more in people with peripheral disease.
Overall, the clinical study provides important insights into the safety and efficacy of PCI with newer stents in patients with concomitant PAD. It indicates that peripheral arterial disease negatively affects modern-day stents much like it affected the old ones.
In conclusion, this clinical trial suggests that narrowing of the blood vessels of the legs is associated with poor outcomes in patients who have undergone PCI with newer heart stents. This allows us to identify patients who are at a higher risk of stent failure and helps us inform them accordingly.
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Atherosclerosis Journal, May-20-22
ClinicalTrials.gov NCT01066650, NCT01331707, NCT01674803, NCT02508714
ClinicalTrials.gov NCT01066650, NCT01331707, NCT01674803, NCT02508714