ISCHEMIC HEART DISEASE: Edited by Peter H. StoneAdverse events beyond 1 year after percutaneous coronary interventionMadhavan, Mahesh V.a,b; Stone, Gregg W.b,cAuthor Information aNewYork-Presbyterian Hospital/Columbia University Irving Medical Center bClinical Trials Center, Cardiovascular Research Foundation cThe Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA Correspondence to Gregg W. Stone, MD, Mount Sinai Hospital, Cardiovascular Research Foundation, 1700 Broadway, 9th Floor, New York, NY 10019, USA. Tel: +1 646 434 4134; fax: +1 646 434 4134; e-mail: [email protected] Current Opinion in Cardiology: November 2020 - Volume 35 - Issue 6 - p 687-696 doi: 10.1097/HCO.0000000000000792 Buy Metrics Abstract Purpose of review To provide a summary and critical appraisal of recent literature pertaining to very late adverse events (>1 year) after revascularization with percutaneous coronary intervention (PCI) with coronary stents. Recent findings Recent studies, including an individual patient-level pooled analysis of randomized trials and network meta-analysis have demonstrated that all coronary stents, including contemporary drug-eluting stents (DES), are associated with an ongoing risk of major adverse cardiovascular events related to the stented region beyond the first year after stent implantation, with rates ranging from 2 to 3% per year for at least 4 years. Patients also remain at additional risk for events originating outside the stented segments because of progressive de novo atherosclerotic disease. Summary Despite improvements in the management of coronary artery disease, patients remain at risk for very late adverse cardiovascular events both arising from the stented regions and other untreated segments of the coronary tree. Further advancements focused on primary prevention, stent design and procedural technique, and secondary prevention will be crucial to reducing rates of very late events and improving symptoms and prognosis of patients after PCI. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.