Our mission is to become a worldwide reference for education in the field for all professionals involved in the process to disseminate knowledge & skills of Acute Cardiovascular Care.
Our mission is to promote excellence in clinical diagnosis, research, technical development, and education in cardiovascular imaging in Europe.
Our mission is to promote excellence in research, practice, education and policy in cardiovascular health, primary and secondary prevention.
Our mission is to reduce the burden of cardiovascular disease through percutaneous cardiovascular interventions.
Improving the quality of life and reducing sudden cardiac death by limiting the impact of heart rhythm disturbances.
Our mission is to improve quality of life and longevity, through better prevention, diagnosis and treatment of heart failure, including the establishment of networks for its management, education and research.
The ESC Working Groups' goal is to stimulate and disseminate scientific knowledge in different fields of cardiology.
The ESC Councils' goal is to share knowledge among medical professionals practicing in specific cardiology domains.
Munich, Germany, Sunday 31 August 2008:Compared with bare metal stents, drug-eluting stents substantially reduce the risk of angiographic and clinical recurrence but do not affect mortality or the short term or long term risk of myocardial infarction.The use of drug-eluting stents necessitates extended treatment with dual antiplatelet therapy (aspirin plus thienopyridine) which may cause bleeding complications and interferes with or even precludes surgery in case this is needed. In addition, from a socioeconomic standpoint, the increased cost associated with drug-eluting stents is a major issue.
Based on these considerations, drug-eluting stents should be avoided(a) when the expected benefit is lowand(b) when the risk associated with extended dual antiplatelet therapy is highAfter placement of bare metal stents, the risk of restenosis varies considerably based on patient and lesion characteristics. Specifically, patients who do not suffer from diabetes have a substantially lower risk than diabetic patients. Strong lesion-specific predictors of a low risk of restenosis after bare metal stents include short lesion length and large vessel size. Thus, in non-diabetic patients with a short lesion in a large vessel, the risk of restenosis after placement of a bare metal stent is below 10%. In these subsets, a substantial benefit from drug-eluting stents cannot be expected. These considerations are confirmed by data from randomized studies as well as from registries.In patients with bleeding disorders, the risk of bleeding complications during dual antiplatelet therapy is particularly high. On the other hand, premature discontinuation of dual antiplatelet therapy for imminent or overt bleeding carries a substantial risk of stent thrombosis with potentially fatal outcome. A particularly difficult patient subset in this respect concerns those in need for anticoagulation, such as patients with atrial fibrillation at high risk for thromboembolic events or patients with prosthetic valve replacement. In these patients, interventional cardiologists are well advised to use a bare metal stent to keep the need for dual antiplatelet therapy as short as possible.Drug-eluting stents should also be avoided in patients with planned surgical procedure and in those likely to undergo a surgery within the next year.
This press release accompanies both a presentation and an ESC press conference given at the ESC Congress 2008. Written by the investigator himself/herself, this press release does not necessarily reflect the opinion of the European Society of Cardiology.
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