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Drug-Eluting Stents in Acute Myocardial Infarction
Is Science Catching Up With Practice?
Mauricio G. Cohen, MD;
E. Magnus Ohman, MD
JAMA. 2005;293:2154-2156.
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In the last 3 to 4 years, the use of drug-eluting stents in clinical practice has revolutionized interventional cardiology. Two pivotal trials using sirolimus- and paclitaxel-eluting stents and reporting previously unheard-of single-digit restenosis rates1-2 heralded a new era for interventional cardiology, suggesting that the most vexing problem for intervention, namely, restenosis, had finally been tackled. These 2 trials predominantly studied patients undergoing elective procedures and found target-lesion revascularization rates of approximately 3% to 4% and postprocedure myocardial infarction rates that ranged from 2.8% to 3.5%.
In the United States, drug-eluting stents were approved by the Food and Drug Administration in April 2003, after approximately 90 000 sirolimus-eluting stents had been distributed outside the United States.3 Despite the fact that simple lesions in low-risk patients were studied in the clinical trials that led to approval of these devices in the United States, the adoption . . . [Full Text of this Article]
Author Affiliations: Division of Cardiology, University of North Carolina at Chapel Hill (Drs Cohen and Ohman)
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