Drug-eluting stents in Cuba: twenty years after their introduction into clinical practice

Abstract

Introduction: In the last two decades there has been a notable evolution and sophistication of coronary drugs-eluting stents, which constitute the turning point, from which, interventional cardiology began to reduce rates of restenosis.

Objective: To synthesize the studies that evaluate the mortality and survival without restenosis, and myocardial infarction after the use of drug-eluting stents in the Cuban population.

Material and Methods: Review of the main biomedical databases with the objective of finding the studies developed in the Cuban population with the use of drug-eluting stents, which were found in five researches.

Results: Three studies compare paclitaxel-eluting stents with conventional stents and two others describe the evolution of patients with sirolimus stent. Average ages are reported to be between 57.8 and 61.5 years. The male sex predominated (78.7%, of the 376 patients enrolled), and high prevalence of coronary risk factors such as: arterial hypertension (71.8%), smoking habit (49.5%), diabetes mellitus (29.9%), and hypercholesterolemia (40.1%). Half of the patients come with the diagnosis of chronic angina, multiarterial disease (52.8%) and complex lesions
(73.8%). Survival without restenosis or non-fatal infarction decreased as follow-up
periods increased and ranged between 77.3% and 100%.

Conclusions: Drugs-eluting stent has a high effectiveness, with a significantly high cardiac event-free survival in the Cuban population that is better in patients treated with sirolimus-eluting stent. It is noted the reduction of restenosis and need for new revascularization of the treated lesion, with a low incidence thrombosis, late (from a month to a year after stent implantation) or very late (after a year).