Why drug-eluting stents?

In my regular review of industry press releases, patents (and applications), peer-reviewed journals and other medtech sources, I am occasionally struck by an article or paper that I find compellingly succinct or clear or detailed — or all of the above. The clinical background and technology development of coronary drug-eluting stents are areas I have monitored and published on through different media (most recently through our industry report), so even a particularly clear article may not provide me with more than a confirmation of my understanding. DESHowever, I find a geeky need (or social networking compulsion) to pass along such articles to my audience. Such is the article (mobile version) in an August 2009 issue of the Journal of the American Academy of Physician Assistants. See the opening, pithy synopsis:

Coronary atherosclerotic disease remains the leading cause of mortality in the industrialized world. One American dies from coronary heart disease (CHD) every minute, with an estimated 1.2 million MIs occurring annually in the United States.1 With the epidemic of obesity in this country and Americans’ increasingly sedentary lifestyle, more patients are at risk of developing CHD than ever before. Additionally, more patients are developing abnormal lipid profiles at younger ages, including elevated LDL and decreased HDL cholesterol levels. Abnormal lipid profiles are a well-documented risk factor for the development of atherosclerosis. The coupling of abnormal lipid profiles with vascular injury promotes atherosclerosis, causing symptomatic CHD, including angina pectoris and MI. When symptoms can no longer be medically managed, more invasive options, including percutaneous intervention (PCI) and coronary artery bypass grafting (CABG), may be advised. This article reviews the factors leading to development of CHD and the evolution of PCI technology, discusses how to identify which patients are the best candidates for drugeluting stent (DES) implantation, and explains how to maintain patient safety after PCI.

See also the 2009 report from MedMarket Diligence on the global coronary stents market at link.

 

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