Document Detail

Safety and efficacy of drug-eluting stents: on-label and off-label perspectives.
MedLine Citation:
PMID:  18418309     Owner:  NLM     Status:  MEDLINE    
Favorable outcomes in multiple randomized trials have resulted in the widespread adoption of drug-eluting stents (DES) during percutaneous coronary intervention (PCI). However, reports of increased stent thrombosis-possibly with increased rates of late death and myocardial infarction (MI)-along with the requirement of an extended course of clopidogrel with DES, have resulted in uncertainties as to which patients should receive DES instead of bare-metal stents (BMS). In most patient and lesion subsets, DES significantly reduce neointimal proliferation (resulting in decreased angiographic restenosis), recurrent angina and ischemia, and the need for subsequent revascularization procedures. DES "off-label" indications include use in patients with multiple lesions and multiple vessels, lesions showing long diffuse disease, very small or very large vessels, true bifurcation lesions, thrombotic lesions, and conditions such as acute MI and chronic total occlusions. For now, pending more data, the risks and benefits of DES for off-label indications must be carefully considered on an individual patient basis.
Giora Weisz; Gregg W Stone
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Reviews in cardiovascular medicine     Volume:  9     ISSN:  1530-6550     ISO Abbreviation:  Rev Cardiovasc Med     Publication Date:  2008  
Date Detail:
Created Date:  2008-04-17     Completed Date:  2008-07-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100960007     Medline TA:  Rev Cardiovasc Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  46-61     Citation Subset:  IM    
Columbia University Medical Center and the Cardiovascular Research Foundation, New York, NY, USA.
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MeSH Terms
Coronary Artery Disease / prevention & control
Coronary Restenosis / etiology,  prevention & control*
Drug Labeling*
Drug-Eluting Stents* / adverse effects
Myocardial Infarction / prevention & control
Physician's Practice Patterns / statistics & numerical data*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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