Millions of people suffer from coronary heart disease, a constriction of the coronary arteries that can lead to heart attack. Since the first dilatation of constricted coronary arteries with a balloon catheter 30 years ago, the treatment of coronary heart disease has evolved impressively. A milestone in this development has been the introduction of stents - small grid wire stents designed to provide steady flow of blood after doctors dilate the diseased blood vessel with the balloon catheter.
Medication-coated stent: life-saving or life-threatening?
As a further major step forward, drug-coated stents were celebrated. They ensure a significantly improved protection against a narrowing of the dilated blood vessel. However, the results of studies proving excitement showed that these stents at the same time slightly increase the risk of later, life-threatening blood clot formation in the stent. Such a stent thrombosis is comparable to a heart attack.
No differences in heart attacks and deaths
Reports of this risk have led to anxiety and anxiety in many heart patients. They can now be largely calmed down. "Because a thorough review of all study data from around 29, 000 patients showed that drug-coated stents in the four-year observation period did not lead to more heart attacks and deaths than normal stents, " explains PD Dr. med. med. Thomas Voigtländer from the Scientific Advisory Board of the German Heart Foundation.
"However, " says the cardiologist, "the use of a drug-coated stent should be carefully considered."
Use of drug-coated stents
Drug-coated stents bring benefits, especially in patients at increased risk of constriction, when, for example, a thin coronary vessel (less than 3 mm) is contracted over a longer distance. Restrained with the use of these stents, however, should be at an increased risk for stent thrombosis, for example, when in advanced coronary heart disease, several vessels are treated simultaneously.
If possible, coated stents should not be used - because of the long-term use of anticoagulant drugs prescribed for them - for example, shortly before planned operations or in patients who have multiple illnesses and need to take a variety of tablets.
Crucial: protection against blood clots
Crucial to the success of any stent therapy is that it comes as possible to no clumping of platelets and thus no thrombosis. Therefore, stent patients must take acetylsalicylic acid (ASA) for life and additionally take the drug clopidogrel for a certain time after use of the stent: for the uncoated stent this is four weeks, for the coated six to twelve months.
"However, successful stent therapy does not change the fact that the patient continues to suffer from coronary heart disease, " emphasizes the Chairman of the German Heart Foundation, Prof. Dr. med. med. Hans-Jürgen Becker: "To a large extent, the heart patient has his own hand in his own hands, because he can slow down the progression of the disease - especially through a healthy diet with Mediterranean diet, regular exercise and the consistent use of the prescribed medication."