Cardiologists have clearly received a message from these and similar reports and are curbing their use of DESs, presumably in mostly off-label patients. One expert has reported that DESs are now used in about 72% of coronary-stent patients in the United States, down from a peak of nearly 90% last year. In Europe, DESs were being used in about 48% of such patients, down from a peak of about 56%.
A 70% rate for DES seems about right based on what's known today, said Dr. Cutlip, also chief medical officer at Harvard Clinical Research Institute, Boston. He highlighted the need to choose between a DES and a BMS on a case-by-case basis.