title: Polymer-Free Drug-Coated Coronary Stents in Patients with Stable Coronary Artery Disease at High Bleeding Risk.
abstract: Patients with stable coronary artery disease (CAD) and a high risk of bleeding are not ideal candidates for a polymer-based drug-eluting stent (DES) because it requires 6-12 months of dual antiplatelet therapy (DAPT) following percutaneous coronary intervention (PCI). The purpose of this review is to assess the angiographic and clinical outcomes of polymer-free drug-coated stents (PF-DCS) in stable CAD patients with a high bleeding risk.
  
  
  
  Several randomized controlled trials (RCTs) have compared angiographic and clinical outcomes of PF-DCS with bare-metal stents (BMS), permanent polymer (PP)-DES, or biodegradable polymer (BP)-DES. However, none of these studies particularly recruited patients with stable CAD and a high risk of bleeding. Furthermore, there are limited data available on duration of DAPT following PF-DCS placement. PF-DCS has a better efficacy and similar safety as compared with BMS. PF-DCS with dual drug is noninferior to currently available PP-DES. Further RCTs are needed to assess the safety and efficacy of PF-DCS to BP-DES and PP-DES comparing shorter to standard durations of DAPT.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, East Tennessee State University, 329 North State of Franklin Rd, Johnson City, TN, USA.
authors.forename: Hemang B
authors.initials: HB
authors.lastname: Panchal
authors.affiliation: Division of Cardiology, Winthrop University Hospital, 259 First Street, Mineola, NY, 11501, USA.
authors.forename: Ramesh
authors.initials: R
authors.lastname: Daggubati
authors.affiliation: Section on Cardiovascular Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA.
authors.forename: David
authors.initials: D
authors.lastname: Zhao
authors.affiliation: Duke University Medical Center, Durham VA Medical Center, 508 Fulton Street (111A), Durham, NC, 27705, USA.
authors.forename: Sunil V
authors.initials: SV
authors.lastname: Rao
authors.affiliation: Department of Internal Medicine, Cardiovascular Research, East Tennessee State University, 329 North State of Franklin Rd, Johnson City, TN, USA. pault@etsu.edu.
authors.forename: Timir
authors.initials: T
authors.lastname: Paul
mesh_terms: D003324:Coronary Artery Disease / Q000628:therapy*; D003328:Coronary Thrombosis / Q000209:etiology; D054855:Drug-Eluting Stents; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D062645:Percutaneous Coronary Intervention; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D011108:Polymers / Q000737:chemistry; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D011108:Polymers
keywords: Bleeding risk; Percutaneous coronary intervention; Polymer-free drug-coated stents; Stable coronary artery disease