Replies to post #912 on SurModics Inc (SRDX)

[iwfal]

Just last month, a paper in the Journal of the American College of Cardiology reported that drugs were as effective as stents in improving blood flow through the coronary arteries in patients who were stable after a heart attack.

Almost certainly true since in multiple comparisons (although most are a little old) between the US and other countries it has been shown that the US aggressive intervention rate (stenting or CABG) is much higher but the mortality is no different.

Recent studies also suggest that for patients with especially serious heart disease, stents may fail to match up to the more-invasive procedure they were supposed to replace: bypass surgery.

Also very probably true. Again been shown that for the same patient type CABG has less cummulative risk of MI or death at 2 or 3 years out then if they were treated with stents - although the CABG risk is mostly at the front end (major surgery complications).

If stents fail to win that face-off, "it will be a major challenge to current practice,"

In the US. Much less so in Europe etc where this is more aligned with current practice anyway.

BTW - This is different than a discussion about whether to DES or to BMS -g-.

[aslan2772]

Thanks Dew, we'll have to examine the 7 year randomized study comparing drugs to drugs plus stents when the results are in at ACC in March. However, since stents have already failed to shown a prolonging of life, I would not expect to see any survival benefit of stents plus drugs over drugs alone. I wonder if freedom from angina or other lifestyle factors will be a metric in that study?

I think the key challenge for stents (BMS or DES) is to provide symptomatic relief without unduely increasing the overall risk of adverse events. That many patients are willing to undergo CABG tells us, I think, something about the severity of the pain associated with this disease.