[Cost-effectiveness of drug-eluting stents: implications for clinical practice and healthcare costs].

Drug-eluting stents (DESs) have been central focused area of interest interventional cardiology ever since the RAVEL study was presented at the meeting of the European Society of Cardiology in September 2001. Their novelty, along with the promising preliminary results published for that study, aroused many expectations.1 Although these expectations have not been fully met and the rate of restenosis is not 0%, a substantial reduction is nonetheless achieved in most patients (including those with not so favorable clinical or angiographic characteristics. In implanted in Spain 2004, 36.5% of all stents placed were DESs. There is still a long way to go before DESs completely replace bare-metal stents, but this does represent a substantial increase in the third year after their introduction. Usage of these new stents in the different autonomous regions of Spain ranges from 56% to 23%.2 In addition to the rapamycin-eluting stent (Cypher®) and paclitaxel-eluting stent (Taxus®) already on the market in Spain, 2 further stents launched in 2005: a tacrolimus-eluting stent (Janus®) and an ABT-578eluting stent (Endeavour®). Other stents are under investigation or in the process of applying for regulatory approval.3