Stents recubiertos en el infarto agudo de miocardio

Despite apparent advances in the use of stents for percutaneous coronary intervention, the target lesion revascularization (TLR) rate remains around 8% and the binary restenosis rate remains around 25% in patients undergoing primary percutaneous transluminal coronary angioplasty with bare metal stents. Preliminary results with drug-eluting stents in nonrandomized studies confirm that their use does not significantly reduce the mortality rate but does lead to significant reductions in TLR and binary restenosis rates. Randomized studies of stent efficacy have shown that the use of drug-eluting stents decreases the TLR rate between 30-60%, depending of the rate observed with bare metal stents. This reduction is not accompanied by a decrease in either mortality or acute myocardial infarction recurrence. The significant reduction in major adverse cardiac events observed is due to a reduction in one type of event: TLR. The restenosis rate is also significantly less with drugeluting than bare metal stents. With regard to safety, it can be concluded that there is no significant difference between drug-eluting and bare metal stents in either acute, subacute or late stent thrombosis. However, the lengths of the studies were such that no data were available on very late stent thrombosis. Neither were there sufficient data to conclude that one type of drug-eluting stent was better than any other.