The long-term safety and widespread use of drug-eluting stents (DESs) is a cause for concern and uncertainty, a study has concluded.
The review, just published in Heart, discusses available safety and efficacy data, factors influencing current practices and perceived value of DESs, and off-label use.
However, a related editorial comments that the balance of risk and benefit for DESs varies by patient subgroup.
In those with on-label indications, the small excess of late stent thrombosis does not appear to compromise safety, and evidence backs use of DESs and administration of antiplatelet treatment as per original study protocols.
However, off-label use has raised concerns about late complications, so future studies should incorporate a range of uses to help decision-making in clinical practice.
The editorial concludes that “until such data become available, empirical extension of dual antiplatelet treatment to at least one year is justified”.