Lessons from the unrestricted use of drug-eluting stents: Insights from the RESEARCH and T-SEARCH registry

Drug-eluting stents have raised the current interventional practice to a new and higher level. With the commercialization of sirolimus- and paclitaxel-eluting stents in 2002 and 2003 respectively, the range of applications for coronary stenting expanded. The growing confidence in these drug-eluting devices is based on their capability to reduce restenosis when compared to bare metal stents. We performed two prospective cohort studies, namely the RESEARCH and T-SEARCH registries, to evaluate the safety and efficacy of both the types of drug-eluting stents in a "real world," unselected patient population, in which they were used in almost every type of coronary lesion. In specific high-risk subsets, the use of sirolimus eluting stent was associated with a better outcome in terms of major adverse cardiac events compared to bare metal stents. The T-SEARCH registry did not show a difference in clinical outcome between both devices up to two years. It is still a topic of debate in some countries whether this new technology should become a standard treatment because of the associated higher costs.