Editorial The Ecology of Stent Thrombosis: A View from a Sociobiological Perspective

The introduction of drug-eluting stents (DES) into clinicalpractice in 2003 ushered in a new era for the mechanical treatment of coronary artery disease (CAD). Along with advancements in antiplatelet therapy and the more wide-spread use of cholesterol and inflammation lowering statin drugs, the need for repeat percutaneous coronary interven-tions after an index procedure has been dramatically reduced at the expense of the relatively small but potentially deadly risk of stent thrombosis (ST). Risk factors for this highly morbid complication of DES implantation include technical procedural issues, certain comorbidites such as diabetes mellitus and renal failure, incomplete endothelialization, acquired incomplete apposition, lesion characteristics, and premature discontinuation of dual antiplatelet therapy.1–3 The latter risk factor represents a common cause of late ST in a majority of patients, a factor that is likely influenced b