Document Detail


Stent thrombosis and duration of dual antiplatelet therapy.
MedLine Citation:
PMID:  21208181     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Stent thrombosis (ST) is a rare complication following coronary stenting; however given the associated serious consequences, in particular death and myocardial infarction, it remains a source of considerable concern for cardiologists. Although no differences have been found between drug-eluting stents (DES) and bare-metal stents (BMS) in terms of early ST, some studies have reported adverse outcomes associated with DES as compared to BMS at long-term follow-up. Delayed endothelial coverage of the stent struts, inflammation and local hypersensitivity due to the interaction between the drug and polymer coating have been characterized to be typical for DES compared to BMS and may prolong the window of vulnerability to ST. Consequently the recommended duration of dual antiplatelet therapy (DAT) was longer with DES than with BMS. Results from studies investigating the optimal duration of DAT remain inconclusive and the current recommendation seems to be that patients undergoing DES implantation should have DAT for at least 6-12 months. Our treatment strategy requires more detailed analysis and should improve as we understand more about the impact of the newer generation DES and variability in antiplatelet therapy response, in addition to the effects of novel therapeutic agents and the availability of more data on the optimum duration of DAT.
Authors:
Alfonso Ielasi; Rasha Al-Lamee; Antonio Colombo
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current pharmaceutical design     Volume:  16     ISSN:  1873-4286     ISO Abbreviation:  Curr. Pharm. Des.     Publication Date:  2010  
Date Detail:
Created Date:  2011-01-28     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9602487     Medline TA:  Curr Pharm Des     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  4052-63     Citation Subset:  IM    
Affiliation:
Interventional Cardiology Unit San Raffaele Scientific Institute Via Olgettina 60, 20100 Milan Italy, alielasi@hotmail.com.
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