Prairie Heart helps bring a revolutionary heart device to rest of nation

SPRINGFIELD -- Some say it's most likely the biggest advance in heart care that we will see in our lifetime. Others consider it the next generation in heart health care. Either way, doctors at Prairie Heart Institute at St. John's Hospital are pleased to help bring it to the rest of the country. PHI is one of a select group of sites nationwide to be involved in the research, clinical trials and development of coated stents. The stents have now been approved by the FDA.

Coated stents are used in angioplasty. More than a million Americans a year undergo angioplasty,
where doctors pull tiny balloons through clogged heart arteries. The balloons are then inflated to briefly open the arteries to allow blood flow. In recent years, doctors have implanted tiny wire latticed coils, called stents, to keep arteries open. However, although the stent stays in place permanently, in about one-fourth of all cases, scar-like tissue fills the artery and the artery closes again. A repeat angioplasty or coronary bypass is needed. But now, a new kind of stent coated with medicines that release into the artery keep cells from growing, thus keeping the artery open longer.

"I expect to see patients with coated stents coming back less often for additional angioplasties or bypasses. In the end, this will save patients money, time and emotional trauma," said Dr. Greg Mishkel of Prairie Heart Institute at St. John's Hospital. "From our physicians' point of view, making coated stents available to patients is a significant breakthrough in cardiac care that will ultimately improve the health and quality of life for millions of Americans. It's a privilege to be one of the first heart programs in the country to research the coated stents and to assist in the development of them."

It is estimated that drug-coated stents could reduce the number of bypass surgeries and repeat angioplasties by 20-30 percent. Also, drug-coated stents will most likely lower the price of caring for patients with heart disease over time. Coated stents will reduce risks as well, particularly for certain patients such as the elderly, people with diabetes and women.

"We are proud to bring the next generation of treatment in heart care to Illinois," said Dr. Mishkel. "Our physicians believe it is their ethical and professional obligation to bring this revolutionary new treatment to our patients as soon as it is approved." More than two dozen people have been on a waiting list for the coated stent at PHI, awaiting FDA approval.

Mishkel anticipates a 70% reduction in the risk of restenosis or re-narrowing of the arteries. There are four main components to a coated stent: a stent, a drug that successfully inhibits restenosis, a polymer coating that serves as the agent by which the drug adheres to the stent, and a stent delivery system to position it at the lesion site in the coronary vessel.

Medication is released over several days and interrupts the normal proliferation of scar tissue cells. It does not kill cells; instead it allows the stent to be covered with the layer of smooth cells that normally line blood cells.

Drug coated stents will reduce risks, particularly for certain patients: the elderly, people with diabetes and women, who have a higher mortality rate during surgery and who have more extensive disease than men when they are diagnosed with cardiovascular disease.

While the new device is improving the health and quality of life for patients, it's also costing Prairie Heart Institute at St. John's Hospital extra money to offer it to patients. But doctors say the coated stent revolutionary device is worth it.

PHI has agreed to absorb a portion of the cost of providing coated stents, because Medicare will cover only a percentage of the costs. "While the initial cost of the procedure impacts PHI, the cost to care for patients over time is reduced because of the improved outcomes," said Jim Zito, executive director of PHI.

Now that the FDA has approved the Johnson & Johnson coated stent, PHI is continuing research with other companies on the coated stent. "While other hospitals around the nation will be using the
Cordis/J & J coated stent for the first time, Prairie Heart is already researching the next advance in coated stents and heart care. We're never satisfied with the status quo and as our clinical trials develop, it's our privilege to help bring the most recent, updated science on heart disease to the public and to our colleagues throughout the country," added Zito.