Drug-eluting stents are a strong therapeutic option for symptomatic CHD, provided patients adhere to prolonged dual antiplatelet therapy to mitigate the risk of in-stent thrombosis.
Supports DES when DAPT adherence is assured; leaves open trials on individualized shorter regimens.
Although DES effectively reduces restenosis, a small but significant number of patients suffer complications of in-stent thrombosis. Thus, each patient's health history should be determined before recommending DES. Patients must understand the importance of post-implantation DAT and the need for continued DAT, potentially for life, in order to reduce complications. Current recommendations advocate at least 12 months of uninterrupted clopidogrel and ASA (lifelong ASA if tolerated). With each new generation of stents, patients experience fewer adverse outcomes and improved quality of life. For the present, DES remains a strong therapeutic option for patients with symptomatic CHD.
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Justice et al. (2009) studied this question.
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