The use of drug-eluting stents versus bare metal stents is controversial in some clinical situations in patients at high risk of bleeding.This study randomized 1606 patients considered at low risk of restenosis but with high risk of bleeding receiving Zotarolimus eluting stent (Endeavor) or conventional stent.The clinical characteristics were similar between the two groups with 26% of diabetics.The rate of target vessel revascularization was 10.7 % for the conventional stent and 5.9 % for zotarolimus-eluting stent.Patients who received the drug-eluting stent had fewer heart attacks and less stent thrombosis with a mean duration of 32 days of double anti aggregation.
Conclusion
In patients at high risk of bleeding and low risk of restenosis, implantation of a zotarolimus-eluting stent followed by a custom length (mean 32 days) antiplatelet therapy, resulted in a lower risk of cardiovascular events compared with patients who received a conventional stent.
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Marco Valgimigli
2014-03-31
Original title: Bare Metal vs. Zotarolimus-eluting stent in Uncertain Drug-eluting Stent Candidates: A Randomized Controlled Trial.