From randomized trials to routine clinical practice: an evidence-based approach for the use of drug-eluting stents

Coron Artery Dis. 2006 Dec;17(8):673-9. doi: 10.1097/MCA.0b013e3280111055.

Abstract

The availability of drug-eluting stents has resulted in a paradigm shift in the management of patients with coronary artery disease with a substantial increase in the percentage of patients being revascularized percutaneously rather than surgically. Since its introduction, there has been a tremendous increase in the use of drug-eluting stents with nearly 90% of patients in the US who undergo percutaneous interventions receiving drug-eluting stents. The promising results of several randomized trials that demonstrated a profound reduction in restenosis rates compared with bare-metal stents, underscores the unprecedented enthusiasm among the cardiology community to adopt this new technology swiftly. Data regarding the safety and superiority of drug-eluting stents abound, and it is imperative for the practicing clinician to review and apply them in appropriate clinical settings. In this review, we present general concepts of drug-eluting stents, and attempt to summarize the available data on the approved drug-eluting stents in a variety of patient and lesion subsets. In addition, we share some insights regarding the potential limitations, and issues specific to drug-eluting stents.

Publication types

  • Review

MeSH terms

  • Angioplasty, Balloon, Coronary / instrumentation*
  • Coated Materials, Biocompatible*
  • Coronary Disease / therapy*
  • Coronary Restenosis / prevention & control
  • Evidence-Based Medicine / methods*
  • Humans
  • Randomized Controlled Trials as Topic*
  • Stents*
  • Treatment Outcome

Substances

  • Coated Materials, Biocompatible