Our mission is to become a worldwide reference for education in the field for all professionals involved in the process to disseminate knowledge & skills of Acute Cardiovascular Care.
Our mission is to promote excellence in clinical diagnosis, research, technical development, and education in cardiovascular imaging in Europe.
Our mission is to promote excellence in research, practice, education and policy in cardiovascular health, primary and secondary prevention.
Our mission is to reduce the burden of cardiovascular disease in Europe through percutaneous cardiovascular interventions.
Our mission is to improve the quality of life of the population by reducing the impact of cardiac rhythm disturbances and reduce sudden cardiac death.
Our mission is to improve quality of life and longevity, through better prevention, diagnosis and treatment of heart failure, including the establishment of networks for its management, education and research.
The ESC Working Groups' goal is to stimulate and disseminate scientific knowledge in different fields of cardiology.
The ESC Councils' goal is to share knowledge among medical professionals practising in specific cardiology domains.
OUR MISSION: TO REDUCE THE BURDEN OF CARDIOVASCULAR DISEASE
‘Patients treated with DES do not live longer’
The largest stent trial ever has found no significant differences in death from any cause or non-fatal MI in patients receiving drug-eluting stents (DES) and bare-metal stents (BMS). The investigator-initiated NORSTENT study, reported in a Hot Line session yesterday, was published simultaneously in the New England Journal of Medicine.
‘Patients treated with DES do not live longer and they do not live better than patients treated with BMS,’ said study presenter Kaare Bonaa from the University of Tromso, Norway. Both contemporary DES and BMS, he added, may be similarly recommended for coronary revascularisation.
‘Although ESC guidelines recommend new DES over BMS as default for coronary revascularisation, this recommendation,’ he said, ‘may need to be modified in light of the NORSTENT findings.’
Aware that findings for bare-metal stents have improved with new stent designs, different metal composition and thinner struts, the NORSTENT investigators felt a re-examination against second-generation DES was needed. The study took place in all eight centres in Norway performing PCI.
Between September 2008 and February 2011, the Norwegian Coronary Stent Trial (NORSTENT), funded by the Norwegian Research Council, randomised 9013 patients with stable or unstable CAD to PCI with either contemporary drug-eluting stents (n=4504) or bare-metal stents (n=4509). In the DES group 96% received everolimus or zotarolimus-eluting stents.
Results at six years showed that the rates of the primary outcome (a composite of death from any cause and non-fatal spontaneous MI) were 16.6% in the DES group and 17.1% in the BMS group. Additionally no differences were found between the two groups for all-cause mortality.
However, the six-year rates of any repeat revascularisation were 16.5% in the DES group and 19.8% in the BMS group (HR 0.76, 95% CI 0.69 to 0.85; P<0.001).
Results from the Seattle Angina Questionnaire show that no differences were found between DES and BMS groups for physical limitation, angina frequency and quality of life.
Bonaa disclosed that on the basis of these results 30 patients would need to be treated with DES to prevent just one repeat revascularisation.
‘As expected, the need for repeat revascularisation was lowered by DES, but this effect was less than anticipated,’ said Bonaa, adding that in some studies it was found to be around half this level.
An accompanying Lancet editorial described the observations as ‘important because they balance the claim by some observers that there is no longer a role for bare-metal stents in PCI because of the superiority of their drug-eluting counterparts in these outcomes’. The editorial added that the trial results ‘should increase confidence’ in choosing bare-metal stents if clinical indications favour that decision and support guideline recommendations endorsing it.
Click here to read other scientific highlights in the full edition of the Congress news.
To access all the scientific resources from the sessions during the congress, visit ESC Congress 365.
About the European Society of Cardiology
The European Society of Cardiology brings together health care professionals from more than 120 countries, working to advance cardiovascular medicine and help people lead longer, healthier lives.
About ESC Congress 2016
ESC Congress is the world’s largest gathering of cardiovascular professionals contributing to global awareness of the latest clinical trials and breakthrough discoveries. ESC Congress 2016 takes place 27 to 31 August at the Fiera di Roma in Rome, Italy. The full scientific programme is here.
© 2017 European Society of Cardiology. All rights reserved