Abstract
Overview
Introduction
While drug eluting stents have been successful in reducing the rate of
restenosis following percutaneous coronary intervention, there have been
safety scares over a new problem: "in-stent thrombosis". Opinion leaders are
divided over the gravity of this problem, but positive safety data are
required to restore physician confidence in drug eluting stents.
Scope
- Review of the acute coronary syndromes (ACS) - the indication that drives
the PCI market.
- Opinion leader commentary on guideline developments and key clinical
trials.
- Review of the key drug classes used in conjunction with PCI and the
current opinion on facilitated PCI.
- Opinion leader discussion of currently marketed stents, key clinical
trials in stents, and the evolution from bare metal to drug eluting stents.
Report Highlights
Since the introduction of PCI the procedure rate has increased dramatically
making it one of the most common interventional procedures for heart disease.
Use of PCI differs across the major markets, with this more aggressive
revascularization strategy receiving greatest uptake in the United States,
where coronary artery disease is most prevalent.
Evidence that facilitated PCI improves clinical outcomes remains inconclusive,
although opinion leaders consider the premature interruption of ASSENT-4 to
advise against facilitation with thrombolytics; the ACC/AHA guidelines suggest
facilitation only in "high risk" patients, whereas the ESC say they find no
evidence to recommend it at all.
While drug eluting stents have been successful in reducing restenosis rates
from 20-30% to single digits, there have been safety scares over a new
problem: "in-stent thrombosis". Cordis' s Cypher and Boston Scientific' s Taxus
have received some unfavourable press, but physicians are still enthusiastic
about Abbott' s new stent, Xience.
Reasons to Purchase
- Understand the PCI market, the driving indications and the drug classes
prescribed in PCI patients.
- Gain physician opinion on current treatment practice and how it might
evolve.
- Understand the negative publicity which has caused the robust drug eluting
stent market to falter.
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