Cardiovascular Clinical Research Center, The Leon H. Charney Division of Cardiology, New York University School of Medicine, New York, NY 10016, USA.
J Comp Eff Res. 2012 Nov;1(6):501-8. doi: 10.2217/cer.12.64.
Drug-eluting stents have dramatically reduced the risk of restenosis, but concerns of an increased risk of stent thrombosis have provided uncertainty about their use. Recent studies have continued to show improved procedural and clinical outcomes with drug-eluting stents both in the setting of acute coronary syndromes and stable coronary artery disease. Newer generation drug-eluting stents (especially everolimus-eluting stents) have been shown to be not only efficacious but also safe with reduced risk of stent thrombosis when compared with bare-metal stents, potentially changing the benchmark for stent safety from bare-metal stents to everolimus-eluting stents. While much progress is being made in the development of bioabsorbable polymer stents, nonpolymer stents and bioabsorbable stent technology, it remains to be seen whether these stents will have superior safety and efficacy outcomes compared with the already much improved rates of revascularization and stent thrombosis seen with newer generation stents (everolimus-eluting stents and resolute zotarolimus-eluting stents).
药物洗脱支架显著降低了再狭窄的风险，但支架血栓形成风险增加的担忧使得其应用存在不确定性。最近的研究继续表明，在急性冠状动脉综合征和稳定型冠状动脉疾病的治疗中，药物洗脱支架在改善手术和临床结果方面具有优势。新一代药物洗脱支架（尤其是依维莫司洗脱支架）不仅有效，而且与金属裸支架相比，支架血栓形成的风险降低，这可能改变了支架安全性的基准，从金属裸支架变为依维莫司洗脱支架。虽然在生物可吸收聚合物支架、非聚合物支架和生物可吸收支架技术的开发方面取得了很大进展，但这些支架是否具有优于新一代支架（依维莫司洗脱支架和 Resolute zotarolimus 洗脱支架）的安全性和有效性结果，还有待观察（已经大大提高了血运重建和支架血栓形成的发生率）。
