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Advances in Pharmacological Sciences
Volume 2012 (2012), Article ID 679013, 6 pages
http://dx.doi.org/10.1155/2012/679013
Review Article

Drug-Eluting Stents in Multivessel Coronary Artery Disease: Cost Effectiveness and Clinical Outcomes

1Department of Pharmacology, Nirma University, Ahmedabad, Gujarat 382 481, India
2Department of Pharmacology, L. M. College of Pharmacy, Ahmedabad, Gujarat 380009, India

Received 2 July 2012; Revised 7 November 2012; Accepted 25 November 2012

Academic Editor: Alex Chen

Copyright © 2012 Kanaiya Panchal et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Multivessel coronary artery disease is more often treated either with coronary artery bypass surgery (CABG) or percutaneous coronary intervention (PCI) with stenting. The advent of drug-eluting stent (DES) has changed the revascularization strategy, and caused an increase in the use of DES in multivessel disease (MVD), with reduced rate of repeat revascularization compared to conventional bare metal stent. The comparative studies of DES-PCI over CABG have shown comparable safety; however, the rate of major adverse cerebrovascular and cardiac events and repeat revascularization was significantly higher with DES-PCI at long term. In diabetic patients with MVD, concern of repeat revascularization with DES-PCI is persistent. More recent, one-year economic outcomes have reported that the CABG is favored among patients with high angiographic complexity. The higher rate of repeat revascularization with DES-PCI in MVD would lead to increased economic burden on patient at long term besides bearing high cost of DES. In diabetic MVD patients, CABG is associated with having better clinical outcomes and being more cost-effective approach when compared to DES-PCI at long term.