PMID- 22435450
OWN - NLM
STAT- MEDLINE
DCOM- 20121213
LR  - 20191112
VI  - 7
IP  - 2
DP  - 2012 Aug
TI  - Stent selection in patients with myocardial infarction: drug eluting, 
      biodegradable polymers or bare metal stents?
PG  - 105-20
AB  - Percutaneous coronary intervention (PCI) has been increasingly used in the last 
      years during interventional procedures in patients with acute coronary syndromes 
      (ACS) including ST elevation myocardial infarction (STEMI) and non-ST elevation 
      myocardial infarction (NSTEMI). In patients with either STEMI, NSTEMI, high risk 
      ACS with EKG changes or cardiac enzymes rises; PCI with bare metal stent (BMS) 
      implantation has been associated with a significant improvement in clinical 
      outcome. Therefore, BMS implantation during primary PCI in STEMI has become a 
      standard of practice. With the introduction of drug eluting stents (DESs) in this 
      decade, the use of these new devices instead of BMSs in patients with STEMI has 
      emerged as a rational PCI alternative in this particular subgroup of patients. In 
      spite of the unquestionable benefits of DESs in terms of reduction of restenosis 
      and TVR, specific concerns have arisen with regard to their long-term safety. 
      High incidence of very late stent thrombosis has been described with these 
      devices, and special attention should be paid in patients with unstable coronary 
      lesions, in which plaque composition and remodeling may play a main role in their 
      safety and long-term outcome. Intraluminal thrombus caused by plaque rupture is 
      the most frequent mechanism of STEMI, in which the necrotic core and thin fibrous 
      cap play a major role. In this context, the use of first DESs designs may be 
      futile or even unsafe because delayed healing may further contribute to plaque 
      instability. Adjunctive invasive imaging tools can improve stent deployment and 
      safety outcome in these lesions with intravascular findings of plaque 
      instability. Recently, other players such as new dedicated antithrombotic BMS 
      designs, including selfexpanding stents or drug-eluting coated balloons, are 
      exploring their potential indications in patients with ACS and myocardial 
      infarction. This paper reports and discusses new stent devices and adjunctive 
      pharmacologic agents. It also mentions and describes the recent patents of 
      devices invented to use in these complex lesions subsets.
FAU - Mieres, Juan
AU  - Mieres J
AD  - Cardiovascular Research Center, Cardiac Unit, Otamendi Hospital, Buenos Aires, 
      Argentina.
FAU - Rodriguez, Alfredo E
AU  - Rodriguez AE
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United Arab Emirates
TA  - Recent Pat Cardiovasc Drug Discov
JT  - Recent patents on cardiovascular drug discovery
JID - 101263805
RN  - 0 (Metals)
RN  - 0 (Polymers)
SB  - IM
MH  - Absorbable Implants/*adverse effects
MH  - Acute Coronary Syndrome/physiopathology/surgery
MH  - Drug-Eluting Stents/adverse effects/*trends
MH  - Humans
MH  - Metals/*therapeutic use
MH  - Myocardial Infarction/drug therapy/physiopathology/*surgery
MH  - Patents as Topic
MH  - Percutaneous Coronary Intervention/*methods
MH  - Polymers/*therapeutic use
MH  - Stents/adverse effects/*trends
MH  - Thrombosis/physiopathology/surgery
EDAT- 2012/03/23 06:00
MHDA- 2012/12/14 06:00
CRDT- 2012/03/23 06:00
PHST- 2011/12/12 00:00 [received]
PHST- 2012/02/01 00:00 [revised]
PHST- 2012/02/02 00:00 [accepted]
PHST- 2012/03/23 06:00 [entrez]
PHST- 2012/03/23 06:00 [pubmed]
PHST- 2012/12/14 06:00 [medline]
AID - PRC-EPUB-20120322-003 [pii]
AID - 10.2174/157489012801227256 [doi]
PST - ppublish
SO  - Recent Pat Cardiovasc Drug Discov. 2012 Aug;7(2):105-20. doi: 
      10.2174/157489012801227256.