title: Statins and stent thrombosis.
abstract: Thrombosis is a rare but serious complication of stent implantation in atherosclerotic arteries, affecting both bare-metal and drug-eluting stents. Diagnostic criteria for stent thrombosis have recently been updated with the time and probability of the event being considered as crucial parameters. To be considered as "definite", the diagnosis of stent thrombosis has to be confirmed by angiography or histology. This statement position has clearly rendered more difficult the clinical assessment of stent thrombosis in randomised clinical trials. Considering these limitations, stent thrombosis represents a dramatic complication for both patients and cardiologists. In coronary plaques, thrombosis is often associated with death, acute coronary syndromes and arrhythmias. For these reasons, the pharmacological improvement of this outcome represents a "hot-topic" field for research. Among several medications, statins have been shown to potentially reduce the incidence of coronary stent thrombosis in humans. However, randomised clinical trials focussing on "definite" diagnosis are still needed to confirm these promising results. In addition, the use of statins in patients implanted with stents in other arteries is largely unexplored. Finally, statin-eluting stents (only tested in pigs) have to be evaluated in other animal models and human beings. Therefore, a clear recommendation on the use of statins to prevent stent thrombosis is not available and caution should be used. The "pleiotropic" anti-atherosclerotic properties of statins might represent a crucial investigation field to pathophysiologically clarify the role of statins in stent complications.
authors.affiliation: Division of Cardiology, Faculty of Medicine, Foundation for Medical Researches, Geneva University, Switzerland. vincent.braunersreuther@unige.ch
authors.forename: Vincent
authors.initials: V
authors.lastname: Braunersreuther
authors.forename: François
authors.initials: F
authors.lastname: Mach
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Montecucco
mesh_terms: D054058:Acute Coronary Syndrome / Q000628:therapy*; D023903:Coronary Restenosis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D003328:Coronary Thrombosis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D054855:Drug-Eluting Stents; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D017239:Paclitaxel / Q000008:administration & dosage; D011474:Prosthesis Design; D020123:Sirolimus / Q000008:administration & dosage; D015607:Stents / Q000009:adverse effects*
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D017239:Paclitaxel; D020123:Sirolimus