Stent thrombosis in real-world patients: a comparison of drug-eluting with bare metal stents

Extract

The introduction of drug-eluting stents (DES) has been associated with an impressive reduction in target vessel revascularisation. This has led to a rapid and widespread adoption throughout the world. However, there has been concern about the safety profile.1 The most dramatic outcome is stent thrombosis, a condition associated with a high mortality rate. In 2003, the FDA published a web notification after receiving numerous reports of subacute stent thrombosis with the sirolimus-eluting stent.2 Theoretically, this may be expected because of the combination of delayed endothelisation of the drug-eluting stent with an increased tendency to platelet aggregation on sirolimus.3,4 The randomised clinical trials, although carried out in selected patients with a relatively short follow-up, could not confirm the suspicion raised.5-7 The question remains whether DES can be applied safely in real-world patients with more complex lesions. The aim of this study was to determine the incidence of stent thrombosis in an unselected cohort of patients and evaluate the contribution of DES. …