A pesar del avance que han supuesto los stents en el intervencionismo cardiaco, la incidencia de revascularización de la lesión tratada (RLT) se mantiene alrededor del 8% y la reestenosis binaria alrededor del 25% en pacientes tratados con angioplastia coronaria percutánea (ACTP) primaria y stents no recubiertos de fármacos (SNR). Resultados preliminares obtenidos con el uso de stents recubiertos de fármacos (SR) en estudios no aleatorizados confirmaron que su uso no redujo significativamente las tasas de mortalidad, pero si consiguió disminuir de manera significativa la RLT y la reestenosis binaria. Con respecto a los estudios aleatorizados sobre su eficacia, su uso disminuye un 30-60% las RLT en función de las tasas de los SNR. Esta reducción no se acompaña de una disminución de muerte ni de reinfarto agudo de miocardio. La reducción significativa de los eventos cardiacos se establece fundamentalmente a expensas de uno de sus componentes, la RLT. En cuanto a la reestenosis, ésta sigue la misma dirección que la RLT, significativamente menor con los SR que con los SNR. En cuanto a la seguridad, puede concluirse que no hay diferencias significativas entre los SR y los SNR, tanto en lo referente a las trombosis del stent (TS) agudas, subagudas o tardías, aunque por la duración de los estudios no tenemos datos de las muy tardías. Tampoco hay datos suficientes que nos permitan concluir que un SR es superior a otro.
Palabras clave
Infarto agudo de miocardio
Angioplastia primaria
Stent recubierto
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