Drug-eluting stents for acute coronary syndromes: should the labeling be expanded?

Compared with bare-metal stents (BMS), first-generation drug-eluting stents (DES), sirolimus-eluting stents and paclitaxel-eluting stents have been shown to reduce restenosis rates and target lesion revascularization following elective percutaneous coronary inter vention [1–3]. However, the initial enthusiasm for DES has been dampened by concerns raised in a number of registries in which the nonrestrictive use of DES was associated with high rates of late stent thrombosis (ST; up to 0.6% per year up to 5 years). These ST rates are higher when compared with those reported for the pivotal trials and are asso ciated with increased rates of morbidity and mortality [4,5]. “...the initial enthusiasm for drug-eluting stents has been dampened by concerns raised in a number of registries in which the nonrestrictive use of drug-eluting stents was associated with high rates of late stent thrombosis.”