Patients receiving drug-eluting stents should continue antiplatelet medications

Armen Hareyan's picture
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Patients who have had drug-eluting stents inserted to prop open blocked coronary arteries should continue to take medications to reduce the risk of blood clots for at least one year after the stent is inserted, a new scientific advisory recommends.

The American Heart Association, American College of Cardiology, Society for Cardiovascular Angiography and Interventions, American College of Surgeons and American Dental Association issued the joint advisory today. It will be published in Circulation: Journal of the American Heart Association, Journal of the American College of Cardiology and Catheterization and Cardiovascular Interventions (CCI): Journal of the Society for Cardiovascular Angiography and Interventions.

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A coronary stent is a wire mesh tube used to prop open a previously blocked artery to the heart. The stent stays in the artery permanently, helping to hold it open, which improves blood flow to the heart muscle and relieves chest pain. Drug-eluting stents are coated with medication which is slowly released to reduce the risk of restenosis, or re-blocking of the artery.

The medications clopidogrel and ticlopidine are in a class of prescription drugs called thienopyridines. Thienopyridines and aspirin are known as antiplatelet agents. They are begun before stent insertion to reduce the chance of clotting within the stent, which may result in heart attack or death.

"Despite this benefit, antiplatelet therapy is sometimes prematurely discontinued within the first year after stent implantation," the advisory warns.

This practice is potentially deadly. Stopping antiplatelet therapy too early after a stent is placed is the leading independent predictor of stent thrombosis

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