Table 6.

Position of European and American guidelines with respect to the use of drug-eluting stents

ESC GL 2014	ESC GL 2010	American societies’ GL
• Unrestricted use of new-generation DES	The use of DES is relatively contraindicated if • Clinical history difficult to obtain, especially in the setting of acute severe clinical conditions (STEMI or cardiogenic shock). • Expected poor compliance with DAPT, including patients with multiple comorbidities and polypharmacy. • Non-elective surgery required in the short-term that would require interruption of DAPT. • Increased risk of bleeding. • Known allergy to ASA or clopidogrel/prasugrel/ticagrelor. • Absolute indication for long-term anticoagulation.	• Before implantation of DES, the interventional cardiologist should discuss with the patient the need for and duration of DAPT and the ability of the patient to comply with and tolerate DAPT. • Balloon angioplasty or BMS should be used in patients with high bleeding risk, inability to comply with 12 months of DAPT, or anticipated invasive or surgical procedures within the next 12 months, during which time DAPT may be interrupted. • DES should not be implanted if the patient is not likely to be able to tolerate and comply with prolonged DAPT or this cannot be determined before stent implantation. • DES should not be implanted if the patient is not likely to be able to tolerate and comply with prolonged DAPT or this cannot be determined before stent implantation.