[Drug-eluting stents: long-term safety]

Area of Science:

• Cardiology
• Biomedical Engineering
• Interventional Cardiology

Context:

• Late stent thrombosis (LST) remains a significant concern following percutaneous coronary intervention.
• Drug-eluting stents (DES) have revolutionized coronary artery disease treatment but carry a risk of LST.
• Understanding LST mechanisms and long-term outcomes is crucial for patient prognosis.

Purpose:

• To review the problem of late stent thrombosis of drug-eluting stents.
• To present long-term results of sirolimus-eluting stents (SES) in coronary heart disease (CHD) patients.
• To compare long-term outcomes of SES versus metallic stents (MS) and identify LST risk factors.

Summary:

• This review analyzes the mechanisms, risk factors, and long-term outcomes associated with late stent thrombosis (LST) in patients receiving drug-eluting stents (DES).
• It presents findings from a trial on sirolimus-eluting stents (SES) and compares 3.5-year follow-up data of SES versus metallic stents (MS).
• Mechanisms of LST development and data from meta-analyses and registries are discussed.

Impact:

• Provides critical insights into the long-term safety and efficacy of sirolimus-eluting stents.
• Identifies key risk factors for late stent thrombosis, aiding in risk stratification and patient management.
• Contributes evidence to inform clinical decisions regarding stent selection for coronary heart disease patients.