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May 17, 2026Journal of the American College of Cardiology

Hypersensitivity Cases Associated With Drug-Eluting Coronary Stents

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Why the study?

Although the FDA initially attributed post-DES hypersensitivity reactions to concomitant medications, reports of hypersensitivity continued, prompting a comprehensive review and causality classification.

Do drug-eluting stents cause systemic and intrastent hypersensitivity reactions in patients undergoing coronary stenting?

Population

Reports of hypersensitivity-like reactions after placement of a DES from April 2003 through December 2004

Comparison

Sirolimus-eluting stent vs paclitaxel-eluting stent

Design

Review of adverse event databases, published literature, and RADAR project reports

Key result

Drug-eluting stents were identified as the probable or certain cause of hypersensitivity reactions in 17 distinct cases, which in some instances were associated with late thrombosis and death.

Authors

JNJonathan R. NebekerRVRenu VirmaniCBCharles L. Bennett

Discussion

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Member takes

Overview

Clinicians should consider drug-eluting stent hypersensitivity in unexplained late thrombosis; leaves open the need for prospective confirmation of causality.

Structured PICO

Do drug-eluting stents cause systemic and intrastent hypersensitivity reactions in patients undergoing coronary stenting?

P
Population
Patients with reported adverse events after placement of a drug-eluting stent (sirolimus-eluting or paclitaxel-eluting) between April 2003 and December 2004 (n=5,783 reports, 262 unique events with hypersensitivity symptoms).
I
Intervention
Drug-eluting stents (sirolimus-eluting or paclitaxel-eluting)
O
Outcome
Hypersensitivity reactions and causality assessment using standardized World Health Organization criteriasafety

Drug-eluting stents may cause systemic and intrastent hypersensitivity reactions that can lead to late stent thrombosis and death, distinct from clopidogrel-induced hypersensitivity.

Cite This Study

Nebeker et al. (2005) conducted a review in Hypersensitivity reactions after drug-eluting stent placement (n=262). Drug-eluting stents (sirolimus-eluting and paclitaxel-eluting) was evaluated on Causality of hypersensitivity reactions assessed using standardized World Health Organization criteria. Drug-eluting stents were identified as the probable or certain cause of hypersensitivity reactions in 17 distinct cases, which in some instances were associated with late thrombosis and death.

synapsesocial.com/papers/6a0988047a6e434167969236https://doi.org/10.1016/j.jacc.2005.07.071
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