Dual antiplatelet therapy and drug eluting stents: a marriage of convenience

In 1977, a major breakthrough in cardiovascular medicine was introduced by Dr. Andreas Gruentzig. In September of that year, Gruentzig performed the very first percutaneous transluminal coronary angioplasty (PTCA) procedure in a human. Twenty-three years later, the coronary artery was still patent. [1] Despite the initial enthusiasm, some complications were clearly associated with the procedure, being restenosis and thrombosis the major problems to deal with. In the early nineties, bare metal stents (BMS) were introduced to avoid the so called "elastic recoil of the artery" leading to restenosis. Despite some improvements in the rates of restenosis and thrombosis, they were still very significant. The introduction of dual antiplatelet therapy (thyenopiridine on top of aspirin) substantially decreased the rate of stent thrombosis, being currently a rare complication occurring in less than 1% of the procedures. [2]