Late thrombosis in drug-eluting coronary stents after discontinuation of antiplatelet therapy

EP McFadden, E Stabile, E Regar, E Cheneau… - The Lancet, 2004 - thelancet.com
EP McFadden, E Stabile, E Regar, E Cheneau, ATL Ong, T Kinnaird, WO Suddath…
The Lancet, 2004thelancet.com
Although the safety profiles of coronary stents eluting sirolimus or paclitaxel do not seem to
differ from those of bare metal stents in the short-to-medium term, concern has arisen about
the potential for late stent thromboses related to delayed endothelialisation of the stent
struts. We report four cases of angiographically-confirmed stent thrombosis that occurred
late after elective implantation of polymer-based paxlitaxel-eluting (343 and 442 days) or
sirolimus-eluting (335 and 375 days) stents, and resulted in myocardial infarction. All cases …
Summary
Although the safety profiles of coronary stents eluting sirolimus or paclitaxel do not seem to differ from those of bare metal stents in the short-to-medium term, concern has arisen about the potential for late stent thromboses related to delayed endothelialisation of the stent struts. We report four cases of angiographically-confirmed stent thrombosis that occurred late after elective implantation of polymer-based paxlitaxel-eluting (343 and 442 days) or sirolimus-eluting (335 and 375 days) stents, and resulted in myocardial infarction. All cases arose soon after antiplatelet therapy was interrupted. If confirmed in systematic long-term follow-up studies, our findings have potentially serious clinical implications.
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