title: 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.
abstract: BACKGROUND
  and Overview. Dual antiplatelet therapy with aspirin and a thienopyridine has been shown to reduce cardiac events after coronary stenting. However, many patients and health care providers prematurely discontinue dual antiplatelet therapy, which greatly increases the risk of stent thrombosis, myocardial infarction and death.
  
  
  CONCLUSIONS
  This advisory stresses the importance of 12 months of dual antiplatelet therapy after placement of a drug-eluting stent and educating patients and health care providers about hazards of premature discontinuation. It also recommends postponing elective surgery for one year, and if surgery cannot be deferred, considering the continuation of aspirin during the perioperative period in high-risk patients with drug-eluting stents.
authors.affiliation: William Beaumont Hospital, Royal Oak, Michigan, USA.
authors.forename: Cindy L
authors.initials: CL
authors.lastname: Grines
authors.forename: Robert O
authors.initials: RO
authors.lastname: Bonow
authors.forename: Donald E
authors.initials: DE
authors.lastname: Casey
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Gardner
authors.forename: Peter B
authors.initials: PB
authors.lastname: Lockhart
authors.forename: David J
authors.initials: DJ
authors.lastname: Moliterno
authors.forename: Patrick
authors.initials: P
authors.lastname: O'Gara
authors.forename: Patrick
authors.initials: P
authors.lastname: Whitlow
mesh_terms: D001241:Aspirin / Q000008:administration & dosage / Q000627:therapeutic use; D003327:Coronary Disease / Q000601:surgery*; D003328:Coronary Thrombosis / Q000517:prevention & control; D004334:Drug Administration Schedule; D004517:Education, Professional; D017558:Elective Surgical Procedures; D006801:Humans; D009203:Myocardial Infarction / Q000517:prevention & control; D010353:Patient Education as Topic; D019990:Perioperative Care; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000517:prevention & control; D011725:Pyridines / Q000008:administration & dosage / Q000627:therapeutic use; D012307:Risk Factors; D015607:Stents; D013997:Time Factors
chemical_list: D010975:Platelet Aggregation Inhibitors; D011725:Pyridines; C446540:thienopyridine; D001241:Aspirin