MoH urged to put medicated stents on 'watch list'

July 02 - July 08, 2007

LAHORE: Although the Pakistan government is paying much attention on improving the state of health of its population there remains a number of areas which demands immediate attention of the health authorities.

Pakistan is importing stents worth US $40-50 million per annum from the US and European countries but the irrational application of 'medicated stents' on cardiac patients is not only causing certain complications for them but also resulting into deaths of those patients who give up medication. According to information, the Federal Drug Authority (FDA) in its split decision had already put the medicated stents on its watch list, but in Pakistan these stents are playing havoc with the lives of patients, as serious complications are being noticed among the cardiac patients who have medicated stents.

Prof Dr Naeem Tareen, Senior Cardiologist and Diplomate of American Board of Cardiology, told PAGE that blood clotting is 10-times more likely to occur in Pakistani heart patients who have medicated stents, compared with the other older bare-metal variety. He asked the Ministry of Health (MoH) to place the drug-coated heart devices known as medicated stents on its 'watch list' like the Federal Drug Authority, USA. The Ministry of Health should closely monitor the efficacy of medicated stents on Pakistani heart population so that increasing rate of mortality linked with the use of medicated stents may be checked.

Prof Dr Naeem Tareen, who is former Chief at the world renowned St. Paul Hospital, Dallas, Texas, Newyork, said that blood clotting is 10-times more likely to occur in Pakistani heart patients. 'The irrational application of medicated stents on cardiac patients is not only causing certain complications for them but also resulting into deaths in those who give up medication. This was due to blood clotting among the cardiac patients who have medicated stents', he added.

Prof Dr Naeem Tareen, who now was practicing at Surgimed Hospital, Lahore said: ''with the present data available and with high rate of non-compliance with medications, I cannot imagine any Cardiologist putting in drug coated stents in Pakistani population''. He was of the view that the drug-coated stents are not meant for Pakistani population because many patients stop taking the anti-coagulant medication after few months. 'If you stop the medication, you are faced with 'almost death' because the risk of clotting is high. I prefer bare-metal stents because they are cheaper and do not cause clotting, if they close, you can easily open it up again', he said. Prof Dr Naeem Tareen, who is also former Chief Executive of Multan Institute of Cardiology, said that drug coated stents use has been focus of attention among American Cardiologists because of blood clots and increasing rate of death particularly among those patients who stop taking medications. Blood clots can lead to heart attacks, which are dangerous for patients having medicated stents, he re-emphasized.

Prof Dr Naeem Tareen, who was trained at Mount Sirai and ST. Vincent Hospital, New York, USA, whose patients include many world leaders and celebrities, was of the firm view that even well off heart patients should not have drug coated stents.

Prof Naeem Tareen, who also treated veteran politician Nawabzada Nasrullah Khan at one time, said that most probably the elderly politician died from clotting from drug coated stent put in by doctors at Islamabad hospital. Prof Naeem Tareen who is also recipient of American Medical Association Physician, recognition award, further said that cardiovascular disease is one of the leading causes of death in Pakistan. Giving reference of World Health Organisation's (WHO) worldwide figures, Prof Tareen stated that a heart attack occurs in every three seconds, and a stroke in every four. He observed: "Cardiovascular is responsible for 18 million deaths around the world, 80-percent of which occur in the developing countries. Being overweight or obese, particularly if weight is carried around the abdomen, is a leading risk factor for heart disease and stroke, reducing the likely age of a first heart attack by between four and eight years. Nevertheless, maintaining a healthy weight and body shape dramatically reduces this risk'', he said.

"Obesity is on the rise in the world due to sedentary lifestyles coupled with inappropriate eating habits. In Pakistan, we need to change our mindset, and become a physically active and health conscious nation", he asserted.

To another question, Tareen said that tobacco smoking causes one-fifth of cardiovascular diseases worldwide and if the current trends continue, 10 million people will die from tobacco-related diseases by 2030, out of which 70 % of deaths will occur in developing countries.