Drug-eluting stents: Results, promises and problems
article
In-stent restenosis is the major drawback of percutaneous coronary interventions, occurring in 10-40% of the patients. Recently, new stents have emerged which are loaded with anti-inflammatory, anti-migratory, anti-proliferative or pro-healing drugs. These drugs are supposed to inhibit inflammation and neointimal growth and subsequently in-stent restenosis. In this review article the results of human clinical studies investigating drug-eluting stents are discussed from a clinical point of view, focussing on the efficacy in the prevention of restenosis and their potential side effects. Both success and failure in the field of drug-eluting stents have been described. Successful devices are the sirolimus-eluting and the polymer-based paclitaxel-eluting stents. Potentially dangerous side effects of drug-eluting stents are adverse drug interactions, incomplete stent apposition and increased in-stent thrombosis rates. Demonstration of long-term efficacy is mandatory since in some animal studies a delayed healing has been observed. Currently, the successful drug-eluting stents are under investigation in all types of lesions. We conclude that the results with some drug-eluting stents are promising, but further evidence on long-term efficacy and safety, also in high-risk subgroups, is needed. © 2004 Elsevier Ireland Ltd. All rights reserved. Chemicals / CAS: abciximab, 143653-53-6; angiopeptin, 113294-82-9; batimastat, 130370-60-4, 130464-84-5; cilostazol, 73963-72-1; cyclosporin, 79217-60-0; cytochalasin D, 22144-77-0; dactinomycin, 1402-38-6, 1402-58-0, 50-76-0; dexamethasone, 50-02-2; estradiol, 50-28-2; everolimus, 159351-69-6; latrunculin A, 76343-93-6; mycophenolic acid, 23047-11-2, 24280-93-1; nitric oxide, 10102-43-9; paclitaxel, 33069-62-4; rapamycin, 53123-88-9; tacrolimus, 104987-11-3; tranilast, 53902-12-8; vasculotropin, 127464-60-2
Topics
Biomedical ResearchDrug-eluting stentsPaclitaxelRestenosisSide effectsSirolimus7 hexanoyltaxolabciximababt 578angiopeptinantiinfective agentbatimastatcilostazolcyclosporincytochalasin Ddactinomycindexamethasoneestradioleverolimuslatrunculin Amammalian target of rapamycinmycophenolic acidnitric oxidepaclitaxelpaclitaxel derivativerapamycintacrolimustranilastunclassified drugvasculotropinartery intima proliferationcancercell cyclecell cycle G1 phasecell migrationcell proliferationclinical trialcoronary artery bypass graftdiabetes mellitusdrug coatingdrug delivery systemdrug efficacydrug eluting stentheart infarctionheart muscle ischemiahigh risk populationhumaninflammationmortalitynonhumanpriority journalrestenosisreviewsmooth muscle fiberthrombocyte activationtreatment failureCoronary RestenosisDrug Delivery SystemsHumansStents
TNO Identifier
238392
ISSN
01675273
Source
International Journal of Cardiology, 99(1), pp. 9-17.
Pages
9-17
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