Long-term outcomes in patients undergoing percutaneous coronary intervention with drug-eluting stents

Abstract

Drug-eluting stents substantially reduce restenosis compared with bare-metal stents and represent a significant advance in percutaneous coronary interventions. Accordingly, drug-eluting stents have been rapidly adopted into practice and are currently used in the vast majority of complex percutaneous coronary procedures. However, in the last 2 years, concerns have been raised regarding their long-term safety, especially regarding the risk of late and very-late stent thrombosis. Delayed endothelial coverage after drug-eluting stent implantation is thought to prolong the window of vulnerability to stent thrombosis, which requires a prolonged dual antiplatelet therapy. Recent registry studies and meta-analyses seem to have provided reassuring results regarding the long-term rates of death and myocardial infarction associated with the use of drug-eluting stents compared with bare-metal stents. However, data are not consistent and concerns remain.

Keywords::

• bare-metal stent
• drug-eluting stent
• percutaneous coronary intervention
• stent thrombosis
• target-lesion revascularization

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.