January 16, 2007Circulation1,137 citations
View Full PaperPrevention of Premature Discontinuation of Dual Antiplatelet Therapy in Patients With Coronary Artery Stents
Structured PICO
Does 12 months of dual antiplatelet therapy prevent stent thrombosis, myocardial infarction, and death in patients with coronary artery stents?
P
Population
Patients with coronary artery stents, specifically drug-eluting stents
I
Intervention
12 months of dual antiplatelet therapy (aspirin and a thienopyridine)
C
Comparator
Premature discontinuation of dual antiplatelet therapy
O
Outcome
Prevention of stent thrombosis, myocardial infarction, and deathhard clinical
This advisory emphasizes the critical importance of completing 12 months of dual antiplatelet therapy after drug-eluting stent placement to prevent severe cardiac events.
Abstract
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.