Polymer-free Drug-Coated Coronary Stents in Patients at High Bleeding Risk

Patients with CAD at bleeding risk received a umirolimus-coated stent or a bare-metal stent, along with dual antiplatelet therapy. A composite end point (cardiac death, MI, or stent thrombosis) and clinically driven target-lesion revascularization occurred less often with the coated stent. Among patients undergoing percutaneous coronary intervention (PCI), it is estimated that 15% or more are at high risk for bleeding. 1 , 2 Such patients are usually excluded from trials of stents and adjunctive therapy, and the default management of their care, supported by current guidelines, 3 , 4 favors the use of either a second-generation drug-eluting stent with a shortened course of dual antiplatelet therapy or a bare-metal stent followed by 1 month of dual antiplatelet therapy. The latter strategy, driven by the need to minimize the risk of bleeding, is associated with a higher risk of restenosis and reintervention than that observed . . .