Should all Stents be Drug-Eluting Stents?
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Introduction: Drug-eluting stents (DES) are used for percutaneous coronary intervention to overcome problems with bare metal stents (BMS).
DES contain mitotic or anti-inflammatory drugs, which prevent re-stenosis and reduce the rate of revascularisation. However, they have been shown to cause late in-stent thrombosis.
Aim: Aim is to review the most recent evidence comparing DES with BMS in terms of efficacy and safety.
Method: Pubmed and Scopus were searched for relevant articles. Seven articles were found, reviewed and analysed.
Discussion: DES did not improve mortality compared with BMS but they reduced the rate of revascularization. Second generation DES showed more of a benefit than BMS. DES showed more benefit in women and in larger coronary arteries.
DES has shown an increased risk of late stent thrombosis compared with BMS and a possible increase in cardiac deaths. Second generation DES seem to be safer.
Conclusion: DES do not show a significant reduction in rates of MIs or cardiac deaths in comparison with BMS, but do show a reduction in revascularization rates.
While there are safety concerns with first generation DES, second generation DES seem to be safe. It does not seem that DES can replace BMS yet, but newer generations of DES have potential.
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