Controversies in the use of drug-eluting stents for acute myocardial infarction: a critical appraisal of the data.
Acute myocardial infarction is a common and life-threatening presentation of coronary artery disease in adults. In the settings of ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction, significant mortality benefit has been observed in randomized trials of coronary stent procedures compared with medical therapy alone. However, data regarding procedural choices, and particularly stent choices, are limited, and significant controversy exists. Drug-eluting stents were introduced in the United States in 2003 and have been widely adopted based on profound reduction in restenosis. Yet recent years have witnessed a decline in use of drug-eluting stents in the setting of myocardial infarction due to long-term safety concerns. We review the current data regarding drug-eluting stent performance relative to bare metal stents in the setting of acute myocardial infarction with regard to effectiveness, safety, and the need for adjunctive long-term pharmacologic therapy.
Sakhuja
Rahul
R
Division of Cardiology, Massachusetts General Hospital, Boston, MA, USA. rsakhuja@partners.org
Mauri
Laura
L
D000328:Adult; D015906:Angioplasty, Balloon, Coronary; D054855:Drug-Eluting Stents / Q000009:adverse effects; D006083:Graft Occlusion, Vascular / Q000453:epidemiology*; D006801:Humans; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D016896:Treatment Outcome
D010975:Platelet Aggregation Inhibitors