Drug eluting stents versus bare metal stents for the treatment of coronary artery disease: A review of the benefits and harms

Abstract

Drug eluting stents (DES) have been found to reduce restenosis and the rate of repeat angiographic procedures related to restenosis. However, an increase in harms with their use has been suspected. Therefore, there may be an important trade-off of efficacy for harms with the use of DES, especially over the long term. We conducted asystematic review and meta-analysis of RCT, examining the efficacy of DES versus bare metal stents (BMS). A separate review was then conducted which included non randomized studies, as well as RCT to evaluate long term harms of DES when compared to BMS. Analysis demonstrated that there was significant efficacy noted for DES over BMS, especially for the sirolimus coated stents. The long-term data demonstrated preserved efficacy of DES with no significant increase in the harms of death, myocardial infarction, stent thrombosis or revascularization for a follow-up extending out to four years.