Drug-eluting stents: from randomized trials to the real world.
Drug-eluting stents have been developed to prevent in-stent restenosis following percutaneous coronary revascularization. In a number of randomized trials, polymer-coated sirolimus- and paclitaxel-eluting stents have been proven to markedly reduce the incidence of angiographic restenosis and repeat revascularization when compared to bare metal stents. Effectiveness of sirolimus-eluting stents in the prevention of restenosis has been confirmed in many subsets of patients and lesions not included in randomized trials, such as in-stent restenosis, chronic total occlusion, acute myocardial infarction, and others. Very promising data in the real world are emerging for utilization of paclitaxel-eluting stents as well. Other drug-eluting stents gave less brilliant results or even true failures, whilst a number of new drugs and stent platforms are under clinical or preclinical evaluation. In this review we describe the main clinical trials on drug-eluting stents, and the most recent informations derived from observational studies and registries. Moreover, preliminary results on new drug-eluting stents are summarized.
Saia
F
F
Catheterization Laboratory, Institute of Cardiology, University of Bologna, Bologna, Italy.
Degertekin
M
M
Lemos
P A
PA
Serruys
P W
PW
D015906:Angioplasty, Balloon, Coronary; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage*; D003327:Coronary Disease / Q000628:therapy; D023903:Coronary Restenosis / Q000517:prevention & control*; D004359:Drug Therapy, Combination; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D017239:Paclitaxel / Q000008:administration & dosage*; D011108:Polymers; D016032:Randomized Controlled Trials as Topic; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents / Q000009:adverse effects
D000972:Antineoplastic Agents, Phytogenic; D007166:Immunosuppressive Agents; D011108:Polymers; D017239:Paclitaxel; D020123:Sirolimus