Long-term clinical safety and efficacy of drug-eluting stents in real-world patients

Abstract

Since the fi rst balloon angioplasty was performed in the late 1970’s, percutaneous coronary intervention (PCI) has undergone rapid transformation to become an essential treatment option for coronary artery disease as an alternative to surgery. PCI is now widely accepted across the globe, with over half a million procedures being performed annually in the United States alone. Coronary stents were developed in the mid-1980s, and the fi rst randomized trials comparing stenting to balloon angioplasty demonstrated improved angiographic and clinical outcomes. Consequently, coronary artery stenting has progressively replaced balloon angioplasty as the preferred method of PCI. In these initial trials, acute stent thrombosis was a major concern because of high morbidity and mortality. The introduction of dual-antiplatelet therapy with aspirin and a thienopyridine (such as Clopidogrel) as well as impro