Drug-eluting stents versus bare metal stents in ST elevation myocardial infarction: from evidence to practice

In 2001, drug-eluting stents (DES) were introduced as a strategy to decrease restenosis and need for re-intervention. As the utilization of DES grew in general practice, there was considerable use of DES in "off-label" patients not evaluated in the initial randomized clinical trials. Single-center and large registry studies were able to demonstrate that the clinical efficacy of DES persisted even in patient subgroups not included in the initial clinical trials. These observations provided support for evaluating DES in STEMI patients. We will consider the evidence that evaluates the relative safety and efficacy of DES compared to BMS in STEMI patients, as well as address practical issues faced in the routine clinical care of these patients.