Optimal Duration of Clopidogrel Use after Implantation of Drug-Eluting Stents — Still in Doubt

As compared with bare-metal stents, drug-eluting stents reduce restenosis in every clinical situation and every type of lesion studied. Why, then, do some cardiologists use drug-eluting stents in 90% of patients and other cardiologists in 10%? The explanation relates primarily to two questions. First, are drug-eluting stents associated with a greater risk of “very late” (>1 year after implantation) stent thrombosis than bare-metal stents? And second, what is the required duration of dual antiplatelet therapy after implantation of drug-eluting stents? Incredibly, the answers to these questions are still unknown.Definitions of stent thrombosis are either insufficiently sensitive or insufficiently specific. . . .