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Internal and Emergency Medicine

, Volume 13, Issue 5, pp 773–774 | Cite as

Drug-eluting stents vs. bare metal stents in elderly patients

  • Federica Leidi
  • Riccardo Schiavon
  • On behalf of Gruppo di Autoformazione Metodologica (GrAM)
THE CUTTING EDGE: RESEARCH UPDATE

Background

The optimal percutaneous coronary intervention (PCI) strategy and dual antiplatelet therapy (DAPT) duration in fragile patients remain unanswered. In clinical practice, fragile patients, such as elderly patients or patients with a high hemorrhagic risk, often receive bare metal stents (BMS) because they are associated with shorter DAPT duration. However, a new-generation drug-eluting stent (DES) followed by a short duration of DAPT appears to be safe and more efficacious in patients at a high risk for bleeding [1], including the elderly population [2]. Moreover, a recent update of the European guidelines [3] recommends the following DAPT duration regardless of stent type: 6 months for stable angina, 12 months for unstable patients (i.e. those with acute coronary syndrome), and, even though with low evidence level, a shorter duration of DAPT in patient with a high risk of bleeding.

Elderly patients represent a fast-growing proportion of patients undergoing PCI; however, few...

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of human and animal rights

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

None.

References

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    Valgimigli M, Bueno H, Byrne RA et al (2018) 2017 ESC focused update on dual antiplatelet therapy in coronary artery disease developed in collaboration with EACTS: the task force for dual antiplatelet therapy in coronary artery disease of the European Society of Cardiology (ESC) and of the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 39:213–260CrossRefPubMedGoogle Scholar
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    Varenne O, Cook S, Sideris G et al (2018) Drug-eluting stents in elderly patients with coronary artery disease (SENIOR): a randomised single-blind trial. Lancet 391:41–50CrossRefPubMedGoogle Scholar
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    Stergiopoulos K, Brown DL (2012) Initial coronary stent implantation with medical therapy vs medical therapy alone for stable coronary artery disease: meta-analysis of randomized controlled trials. Arch Intern Med 172:312–319CrossRefPubMedGoogle Scholar

Copyright information

© SIMI 2018

Authors and Affiliations

  • Federica Leidi
    • 1
    • 2
  • Riccardo Schiavon
    • 1
    • 2
  • On behalf of Gruppo di Autoformazione Metodologica (GrAM)
  1. 1.Department of Biomedical and Clinical Sciences Luigi SaccoUniversity of MilanMilanItaly
  2. 2.ASST Fatebenefratelli SaccoMilanItaly

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