Long-term outcomes in patients undergoing percutaneous coronary intervention with drug-eluting stents

Drug-eluting stents substantially reduce restenosis compared with bare-metal stents and represent a significant advance in percutaneous coronary interventions. Accordingly, drug-eluting stents have been rapidly adopted into practice and are currently used in the vast majority of complex percutaneous coronary procedures. However, in the last 2 years, concerns have been raised regarding their long-term safety, especially regarding the risk of late and very-late stent thrombosis. Delayed endothelial coverage after drug-eluting stent implantation is thought to prolong the window of vulnerability to stent thrombosis, which requires a prolonged dual antiplatelet therapy. Recent registry studies and meta-analyses seem to have provided reassuring results regarding the long-term rates of death and myocardial infarction associated with the use of drug-eluting stents compared with bare-metal stents. However, data are not consistent and concerns remain.