In New England Journal of Medicine, Dr. Andrew Marks Explains Benefits of Coated Stents and Forecasts that New Research Will Focus on the Longevity of the Inhibitory Effects; Subgroups Who are More Resistant and Possible Oral Therapies


New York, October 1, 2003 – Dr. Andrew Marks, a leading cardiology researcher who was the first to develop the idea for coating stents with sirolimus (rapamycin) as a means for preventing restenosis in patients with coronary artery disease, writes in the October 2 issue of the New England Journal of Medicine that recent research illustrates the success of the treatment while raising important new questions. Dr. Marks, chair of the Department of Physiology and Cellular Biophysics at Columbia University College of Physicians & Surgeons (P&S), authored a “Perspective” piece in the publication, “Sirolimus for the Prevention of In-Stent Restenosis in a Coronary Artery.”


Dr. Marks theorized in the early 1990s that sirolimus (rapamycin) might be effective in inhibiting the proliferation of vascular smooth-muscle and eventually determined that it was a potent inhibitor of coronary restenosis. In 2003, the Food & Drug Administration approved the use of rapamycin-coated stents to prevent restenosis and they are now used in many patients.


Dr. Marks writes in the Journal that recent clinical trials using rapamycin-coated stents have shown that restenosis has been reduced by as much as 26%. He says that the ongoing research has also identified key questions in the advancement of these stents as a treatment in coronary artery disease patients. For example, Dr. Marks says it is too early to determine how long the inhibitor effects of sirolimus will last in patients, which will be crucial in determining its potential as a long-term treatment. He also says that the trials are only just beginning to identify possible subgroups who do not respond as well to the treatment. For example, some trials show that restenosis may be higher in diabetics, even when they have been treated with rapamycin-coated stents. Dr. Marks is currently conducting research into possible oral sirolimus therapy to determine if it has a similar inhibitory ability as that of the drug-eluting stents.


Dr. Marks says “The findings of recent clinical trials are encouraging and support our initial belief that rapamycin-coated stents can be effective in preventing the problem of restenosis in patients with coronary artery disease. But these studies are also helping us to identify where further research should be focused and show us that there is still a need to better understand the basic mechanism by which rapamycin inhibits in-stent restenosis.”



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Annie Bayne                                                  Sarah Compton

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Columbia University College of Physicians & Surgeons

Established in 1767, Columbia’s College of Physicians & Surgeons was the first institution in the country to grant the M.D. degree. Among the most selective medical schools in the country, the school is also home to the largest medical research enterprise in New York state and one of the largest in the country. New York-Presbyterian Hospital is the primary teaching hospital for the Columbia University College of Physicians & Surgeons, providing international leadership in biomedical research and patient care. Columbia’s Department of Physiology and Cellular Biophysics is one of the nation’s premier scientific groups focusing on cellular physiology, cardiovascular biology, and neurobiology research.