[Antithrombotic therapy after percutanous coronary intervention with stenting].
BACKGROUND
Patients with stent thrombosis have a serious prognosis and a high mortality. Insufficient blood platelet inhibition may be the cause of the condition. This article reviews patients--with stents in their coronary arteries--that have had documented effects of long-term blood platelet treatment.


METHODS
The article is based on literature identified through a Pubmed search and own experience.


RESULTS
Premature discontinuation of acetylsalicylic acid and/or clopidogrel, and non-cardiac surgery shortly after stenting are commonly associated with stent thrombosis. Elective non-cardiac surgery should be done without discontinuation of blood platelet inhibitors when possible. It should be delayed for a minimum of 6 weeks after implantation of bare metal stents and for a minimum of 6 months after drug-eluting stents. For patients who need anticoagulation bare metal stents are preferred, and a combination of warfarin, acetylsalicylic acid and clopidogrel should be used as antithrombotic medication.


CONCLUSIONS
It is important to provide adequate information about correct antithrombotic drug use to patients, physicians and pharmacies in order to avoid stent thrombosis and acute myocardial infarction.
Vik-Mo
Harald
H
Hjertemedisinsk avdeling, St. Olavs Hospital, 7006 Trondheim. harald.vik-mo@ntnu.no
Slette
Morten
M
Hegbom
Knut
K
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D000925:Anticoagulants / Q000008:administration & dosage*; D001241:Aspirin / Q000008:administration & dosage; D000077144:Clopidogrel; D054855:Drug-Eluting Stents / Q000009:adverse effects; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006801:Humans; D009203:Myocardial Infarction / Q000209:etiology / Q000517:prevention & control; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D013997:Time Factors; D014859:Warfarin / Q000008:administration & dosage
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; D014859:Warfarin; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin