title: Dual antiplatelet therapy, drug-eluting stents and bioresorbable vascular scaffolds: Evolutionary perspectives.
abstract: Dual antiplatelet therapy reduces the risk of myocardial infarction, stent thrombosis, and cardiovascular mortality after percutaneous coronary intervention, but the optimal duration of therapy remains unclear. Stent thrombosis, one of the most feared complications of coronary intervention, is associated with high mortality and morbidity and is related in part to technical and patient-specific factors. Advances in device technology and better understanding of the pathophysiology of stent thrombosis have reduced the frequency of this devastating complication. Bioresorbable vascular scaffolds possess a number of advantageous features and are currently undergoing active investigation. Bioresorbable vascular scaffolds have been demonstrated to restore physiologic vasomotion, allow for late lumen enlargement, and upon full resorption remove the nidus for very late polymer reactions and resolve concerns of stent malapposition and side branch jailing. Based on the results from recent large-scale randomized trials, the optimal duration of dual antiplatelet therapy may depend on the choice of device type, as well as the individual patient risk of ischemic versus hemorrhagic complications.
authors.affiliation: Division of Cardiovascular Diseases-Montefiore Medical Center, Albert Einstein College of Medicine, New York, New York.
authors.forename: Felipe N
authors.initials: FN
authors.lastname: Albuquerque
authors.affiliation: Division of Cardiovascular Diseases-Montefiore Medical Center, Albert Einstein College of Medicine, New York, New York.
authors.forename: Anna
authors.initials: A
authors.lastname: Bortnick
authors.affiliation: ThoraxCenter, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Javaid
authors.initials: J
authors.lastname: Iqbal
authors.affiliation: ThoraxCenter, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Ishibashi
authors.affiliation: Columbia University Medical Center/New York-Presbyterian Hospital, New York, New York.
authors.forename: Gregg W
authors.initials: GW
authors.lastname: Stone
authors.affiliation: ThoraxCenter, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
mesh_terms: D020341:Absorbable Implants; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D003328:Coronary Thrombosis / Q000209:etiology / Q000517:prevention & control; D004059:Diffusion of Innovation; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D054855:Drug-Eluting Stents; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D008670:Metals; D009203:Myocardial Infarction / Q000209:etiology / Q000517:prevention & control; D018579:Patient Selection; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D011474:Prosthesis Design; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D008670:Metals; D010975:Platelet Aggregation Inhibitors
keywords: bioresorbable vascular scaffolds; dual anti-platelet therapy; stent thrombosis