Drug-Eluting Stent Restenosis Rates?
The article by Lemos et al1 describing coronary restenosis after implantation of sirolimus-eluting stents is of great interest. With the increasing demand for drug-eluting stents (DES) and the recent formation of guidelines for their use, confirmation of their continued efficacy in reducing restenosis is important. Therefore, registry data from a large patient population such as the Thoraxcenter (Rotterdam, the Netherlands)—probably the largest DES patient population in the world—is greatly welcomed.
The authors state that coronary angiography was performed at follow-up for two reasons, ie, if clinically indicated or for “complex” patients. The Results section describes 121 of the 192 patients with complex characteristics. Nineteen of these patients had restenosis, which, although not stated, translates into a restenosis rate of 19/121 (16%). The results make no mention of the patients who had coronary angiography performed for clinical reasons, ie, symptoms or positive ischemic tests. Some of the complex patients are presumably included in this group also. However, it would be most helpful to know the following.
The total number of patients who have had a DES implanted.
The number (%) of the above who represented with clinical evidence suggesting restenosis.
The number (%) of these patients who underwent repeat angiography and had angiographic restenosis identified.
This information, if available, would be clinically relevant and, hopefully, help all interventionists in their struggles to promote DES use.