What are the 2011 ACC/AHA/SCAI treatment guidelines for percutaneous coronary intervention (PCI) and bare-metal stents (BMS) or drug-eluting stents (DES) for myocardial infarction (MI, heart attack)?

Updated: May 07, 2019
  • Author: A Maziar Zafari, MD, PhD, FACC, FAHA; Chief Editor: Eric H Yang, MD  more...
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Answer

The 2011 ACCF/AHA/SCAI guidelines for PCI provides the following guidance with regard to the selection of bare-metal stents (BMS) or drug-eluting stents (DES) [129] :

  • Before DES implantation, the need for, and duration of, dual antiplatelet therapy (DAPT) and the ability of the patient to comply with and tolerate DAPT should be discussed with the patient. (Class I, level of evidence: C)
  • DES are useful alternatives to bare-metal stents (BMS) to reduce the risk of restenosis in cases in which there is an elevated risk of restenosis and the patient is likely to be able to tolerate and comply with prolonged DAPT. (Class I, level of evidence: A)
  • BMS should be used in patients with high bleeding risk, an inability to comply with 1 year of DAPT, or anticipated invasive or surgical procedures in the next 1 year. (Class I, level of evidence: B)
  • DES implantation should not be performed in patients who are probably unable to tolerate or comply with a prolonged course of DAPT. (Class III, level of evidence: B)

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