Drug eluting stents: friend or foe? A review of cellular mechanisms behind the effects of Paclitaxel and sirolimus eluting stents.
Coronary artery disease continues to be an important cause of mortality and morbidity. Sirolimus and paclitaxel eluting stents have become an important treatment for patients undergoing revascularization from coronary blockages. These drug eluting stents have enjoyed great success initially in preventing recurrences of adverse cardiac events and decreasing the incidences of repeat revascularizations. However, adverse effects, such as thrombosis, emanating from the use of these drug eluting stents has recently come to focus. Hence a better understanding of the mechanism of action of these drugs in preventing restenosis is important for the long term success and potential betterment of drug eluting stent technology. Herein we review and discuss the pathophysiology of restenosis, the basic mechanism of action of sirolimus and paclitaxel eluting stents and their limitations so as to create a scope for more efficient and novel drug eluting stents in the future.
Chatterjee
Subroto
S
Department of Pediatrics, Lipid Research and Artherosclerosis Division, Johns Hopkins School of Medicine, Baltimore, Maryland 21205, USA. schatte2@jhmi.edu
Pandey
Ambarish
A
D000818:Animals; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D054855:Drug-Eluting Stents / Q000009:adverse effects; D006083:Graft Occlusion, Vascular / Q000503:physiopathology / Q000517:prevention & control*; D006801:Humans; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D020123:Sirolimus / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*
D000972:Antineoplastic Agents, Phytogenic; D017239:Paclitaxel; D020123:Sirolimus