Therapy Considerations in Drug-Eluting Stents

Approximately 12 million Americans have coronary artery disease, and almost one in five deaths in the United States can be attributed to this disease. In addition, 1.2 million Americans undergo cardiac catheterization and over one-half million receive a percutaneous coronary intervention such as balloon angioplasty, atherectomy, or stent implantation annually. This article will provide an overview of (1) atherosclerosis, the progressive disease which can lead to thrombotic events and/or the development of hemodynamically significant coronary artery lesions; (2) restenosis, the reappearance of significant lesions after coronary interventions such as stent placement; and (3) drug-eluting stents, the devices which, by using appropriate polymers to elute the appropriate drug with the appropriate pharmacokinetics, have almost completely eliminated restenosis.