Lower very late stent thrombosis with everolimus eluting stents (EES)

Lower very late stent thrombosis with everolimus eluting stents (EES)

Though drug eluting stents have a much lower incidence of restenosis after percutaneous coronary intervention, late stent thrombosis and very late stent thrombosis occurring beyond one year after stent implantation are of great concern. This is especially when the individual needs withdrawal of dual antiplatelet therapy for a surgical procedure. A study by Lorenz Räber, Michael Magro, Giulio G Stefanini, Bindu Kalesan, Ron T van Domburg, Yoshinobu Onuma, Peter Wenaweser, Joost Daemen, Bernhard Meier, Peter Jüni, Patrick W Serruys and Stephan Windecker have given some relief in that everolimus eluting stents have been shown superior to sirolimus eluting stents and paclitaxel eluting stent [1]. They evaluated a cohort of over twelve thousand patients with unrestricted use of drug eluting stents of which over three thousand and eight hundred had sirolimus eluting stents, over four thousand three hundred had paclitaxel eluting stents and over four thousand and two hundred had everolimus eluting stents implanted. The overall rate of thrombosis over the follow which ranged up to four years was 1.4 per hundred person-years for everolimus eluting stents. The figure was 2.9 for sirolimus eluting stents and 4.4 for paclitaxel eluting stents (p<0.0001). The rates of early and late stent thrombosis were also similarly lower. There was also a lower risk of death or myocardial infarction with everolimus eluting stents when compared to paclitaxel eluting stents (p<0.0001) which was directly related to the stent thrombosis associated events.

Reference

  1. Lorenz Räber, Michael Magro, Giulio G Stefanini, Bindu Kalesan, Ron T van Domburg, Yoshinobu Onuma, Peter Wenaweser, Joost Daemen, Bernhard Meier, Peter Jüni, Patrick W Serruys, Stephan Windecker. Very Late Coronary Stent Thrombosis of a Newer-Generation Everolimus-Eluting Stent Compared With Early-Generation Drug-Eluting Stents. A Prospective Cohort Study. Circulation. 2012 Mar 6;125(9):1110-21.