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

Excerpt

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. …