Drug-Eluting vs. Bare-Metal Stents: Weighing a Lower Restenosis Rate Against Late Thrombosis

Compared with bare-metal stents (BMS), drug-eluting stents (DES) are associated with lower rates of repeat percutaneous coronary intervention (PCI) but also with a poorly defined excess risk for late thrombosis. In this study, investigators used a decision-analysis model to assess the trade-offs between strategies using DES and BMS for PCI and, in particular, the rates of late thrombosis at which risks for late thrombosis would outweigh restenosis advantages of DES.

Rates of procedure-related morbidity and mortality were taken from published literature. If late thrombosis rates were assumed to be equal for DES and BMS after the first year (i.e., no excess late thrombosis with DES), then strategies using DES were superior. But excess late thr…