Compared with bare metal stents, drug-eluting stents substantially reduce the risk of angiographic and clinical recurrence but do not affect mortality or the short term or long term risk of myocardial infarction. The use of drug-eluting stents necessitates extended treatment with dual antiplatelet therapy (aspirin plus thienopyridine) which may cause bleeding complications and interferes with or even precludes surgery in case this is needed.
In addition, from a socioeconomic standpoint, the increased cost associated with drug-eluting stents is a major issue.