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The availability of drug-eluting stents has resulted in a paradigm shift in the management of patients with coronary artery disease with a substantial increase in the percentage of patients being revascularized percutaneously rather than surgically. Since its introduction, there has been a tremendous increase in the use of drug-eluting stents with nearly 90% of patients in the US who undergo percutaneous interventions receiving drug-eluting stents. The promising results of several randomized trials that demonstrated a profound reduction in restenosis rates compared with bare-metal stents, underscores the unprecedented enthusiasm among the cardiology community to adopt this new technology swiftly. Data regarding the safety and superiority of drug-eluting stents abound, and it is imperative for the practicing clinician to review and apply them in appropriate clinical settings. In this review, we present general concepts of drug-eluting stents, and attempt to summarize the available data on the approved drug-eluting stents in a variety of patient and lesion subsets. In addition, we share some insights regarding the potential limitations, and issues specific to drug-eluting stents.

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Introduction: Heart Failure (HF) patient engagement after hospital discharge is key to preventing readmission and compliance. According to Medicare Hospital Compare the average rate of unplanned readmission is 21.6% Objective: The Rise Above Heart Failure™(RAHF) pilot program was created to identify strategies to reduce the burden of common HF complications and ultimately reduce hospitalization. The pilot included targeted quality improvement strategies, provider engagement, and a redesigned patient journey. Methods: Three North Texas pilot sites received quality improvement consultation and measured their progress towards improved guideline-directed care by tracking the impact to the 1,347 patients discharged with heart failure in Get With The Guidelines®-Heart Failure (GWTG-HF). The RAHF Pilot Program focused on engaging key stakeholders who working in partnership with AHA staff, developed a new patient journey for patients in the pilot. Results: The percent of HF patients who received 60 minutes of heart failure education by a qualified heart failure educator was analyzed and yielded the following results: the program hospitals saw an average adherence of 51.0% in Q2 and 53.9% adherence in Q4 (%Δ =5.8%). Additionally, the pilot program’s average of 50.47% during Q2-Q4 was more than 10% greater than the national average during the same time period. In the outpatient setting, HF PATH app users completed both a pre and post knowledge assessment between Oct 2019 - March 2020. A perfect score on the assessment is 19. The average pre-score for these participants is 16.33, while the average post-score for these participants is 17. Conclusions: Midterm results indicate that the program is successfully increasing HF patient education to increase patient awareness and understanding of HF, as represented by higher adherence to the 60 Minutes of Heart Failure Education measure and positive trends in the HF Path app knowledge assessment scores.