Prevention of premature discontinuation of dual antiplatelet therapy in patients with coronary artery stents: a science advisory from the American Heart Association, American College of Cardiology, Society for Cardiovascular Angiography and Interventions, American College of Surgeons, and American Dental Association, with representation from the American College of Physicians.
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.
Grines
Cindy L
CL
Bonow
Robert O
RO
Casey
Donald E
DE
Gardner
Timothy J
TJ
Lockhart
Peter B
PB
Moliterno
David J
DJ
O'Gara
Patrick
P
Whitlow
Patrick
P
D026683:Advisory Committees; D001241:Aspirin / Q000592:standards / Q000627:therapeutic use; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000592:standards; D020099:Coated Materials, Biocompatible / Q000592:standards / Q000627:therapeutic use; D003328:Coronary Thrombosis / Q000209:etiology / Q000517:prevention & control; D004359:Drug Therapy, Combination; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000592:standards* / Q000627:therapeutic use*; D011725:Pyridines / Q000592:standards / Q000627:therapeutic use; D015607:Stents / Q000009:adverse effects / Q000592:standards*; D013997:Time Factors; D014481:United States
D020099:Coated Materials, Biocompatible; D010975:Platelet Aggregation Inhibitors; D011725:Pyridines; C446540:thienopyridine; D001241:Aspirin