Key Role of Platelets in the Natural History

Neointimal proliferation after stent implantation remains aconcern even if local delivery of various antimitotic drugs has led to a significant reduction in smooth cell proliferation and a subsequent reduction in the rate of target vessel revascularization. The prevention of arterial restenosis in those treated by percutaneous coronary intervention using such new-generation stents fails in approximately 10 % of patients, contributing to recurrent ischemic events and new revascularization procedures. Thus far, the systemic approach with statins, pioglitazone, angiotensin-converting enzyme inhibitors, and various antiproliferative drugs has not been successful in further reducing in-stent stenosis, raising the question of whether the aim included the right targets. See accompanying article on page 238