22 Jan 07

Prevention of premature discontinuation of dual antiplatelet therapy in patients with coronary artery stents

Posted in Anesthesia, Anticoagulation, Pre-operatie evaluation at 20:08 by Laci

By CL Grines, RO Bonow, DE Casey Jr, TJ Gardner, PB Lockhart, DJ Moliterno, P O’Gara and P Whitlow

Circulation 2007; 115:813-818

Dual antiplatelet therapy with aspirin and a thienopyridine has been shown to reduce cardiac events after coronary stenting. However, many patients and healthcare providers prematurely discontinue dual antiplatelet therapy, which greatly increases the risk of stent thrombosis, myocardial infarction, and death. This advisory stresses the importance of 12 months of dual antiplatelet therapy after placement of a drug-eluting stent and educating the patient and healthcare providers about hazards of premature discontinuation. It also recommends postponing elective surgery for 1 year, and if surgery cannot be deferred, considering the continuation of aspirin during the perioperative period in high-risk patients with drug-eluting stents.

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