DES vs BMS:
iwfal and I have debated this on the Biotech Values board, where I’ve taken the position that the cumulative mortality rate is not the only metric I would use to guide a DES vs BMS decision for myself or a family member. Why not? Because:
1. With restenosis, you have some control over outcomes. For instance, you can seek out a better-than-average doctor and, if you know your stuff, you can avert being pressured into an unnecessary TVR.
2. With late thrombosis, on the other hand, you have little or no control over your outcome. You will end up in an ER and half the time you’ll be a goner.
3. Data that purport to show that the cumulative risk of DES’s is <= the cumulative risk from BMS’s are flawed. Not only because of the “horizon effect” that FP mentioned in a prior post, but also because no one knows the risk of taking Plavix forever. In particular, what happens if you need to undergo elective surgery for something unrelated to the original problem?
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If I had to make a decision today, I would opt for a BMS. This could change when the MDT and CONR stents become available. JMHO, FWIW
“The efficient-market hypothesis may be
the foremost piece of B.S. ever promulgated
in any area of human knowledge!”
