Outcomes Following Coronary Stenting in the Era of Bare-Metal vs the Era of Drug-Eluting Stents

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Abstract
There has been a growing concern about the possibility of an increased risk of stent thrombosis (ST) associated with the use of drug-eluting stents compared with bare-metal stents. Although a relatively rare event, stent thrombosis is associated with a high risk of myocardial infarction (MI) and death1-9 and any suggestion of possible excess risk has justifiably been the focus of intense investigation. Although the initial US Food and Drug Administration (FDA) public health warning raised the specter of an increased risk of early (within 30 days), subacute thrombosis,10 trial-level meta-analyses raised concerns about an increased risk of late thrombosis (>30 days).11,12 Despite several recent studies, including patient-level meta-analyses8,13-15 and large registry reports,16-21 there remains uncertainty about the trade-offs between the safety and effectiveness of drug-eluting stents.22-26