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- Heart-healthy diet: 8 steps to prevent heart disease
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- Niacin to boost your HDL, 'good,' cholesterol
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Drug-eluting stents: Do they increase heart attack risk?
What should you do if you have a drug-eluting stent?
It's very important that you take anti-clotting medications exactly as directed by your doctor. Here's what to do if you have a stent of any kind:
- Take aspirin. If you have a stent, you'll have to take aspirin daily and indefinitely to reduce the risk of clotting. Follow your doctor's instructions on how much and what type of aspirin to take.
- Take anti-clotting medication. People with stents are given prescription anti-clotting medications, such as clopidogrel (Plavix). The American Heart Association and Food and Drug Administration recommend that people who have had drug-eluting stents inserted should continue to take medications, such as clopidogrel, to reduce the risk of stent clotting for at least one year after the stent is inserted. In some high-risk situations, your cardiologist may recommend taking clopidogrel indefinitely.
- Listen to your cardiologist. Always talk with your cardiologist about how long you should take anti-clotting and other medications because the answer will vary depending on the nature of your blockage and your risk of bleeding. The most important thing to remember is to take all your medications exactly as your doctor prescribes.
- Talk to your other health care providers. It's important to let your primary care doctor and any other specialists you see know what medications you take and that you have a stent. Anti-clotting medications and aspirin can affect surgeries and other medical procedures, and may interact with other medications.
What if I need other surgeries?
If you're considering surgery not related to your heart (noncardiac surgery) in the year after receiving your stent, there are some additional things to keep in mind:
- If possible, you should postpone your noncardiac surgery for one year after receiving a stent.
- If the surgery can't be postponed, discuss with your doctor medications you should be taking at the same time, such as aspirin or clopidogrel. Your medication dosages might need to be changed.
- If you're likely to need surgery in the year after you get a stent, a bare-metal stent may be a better treatment for you. You may also want to consider a bare-metal stent if you're at an increased risk of bleeding or don't think you'll be able to take anti-clotting medications as prescribed by your doctor. Talk with your doctor about your situation.
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- Stents. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/stents/stents_all.html. Accessed March 23, 2011.
- Stone GW, et al. Safety and efficacy of sirolimus- and paclitaxel-eluting coronary stents. New England Journal of Medicine. 2007;356:998.
- Stone GW, et al. Paclitaxel-eluting stents versus bare-metal stents in acute myocardial infarction. New England Journal of Medicine. 2009;360:1946.
- Mauri L, et al. Drug-eluting or bare-metal stents for acute myocardial infarction. New England Journal of Medicine. 2008;359:1330.
- Mauri L, et al. Stent thrombosis in randomized clinical trials of drug-eluting stents. New England Journal of Medicine. 2007;356:1020.
- Douglas PS, et al. Clinical effectiveness of coronary stents in elderly persons: Results from 262,700 Medicare patients in the American College of Cardiology-National Cardiovascular Data Registry. Journal of the American College of Cardiology. 2009;53:1629.
- Kaiser C, et al. Drug-eluting versus bare-metal stents in large coronary arteries. New England Journal of Medicine. 2010;363:2310.
- Sakhuja R, et al. Controversies in the use of drug-eluting stents for acute myocardial infarction: A critical appraisal of the data. Annual Review of Medicine. 2010;61:215.
- Liistro F, et al. Long-term effectiveness and safety of sirolimus stent implantation for coronary in-stent restenosis: Results of the TRUE (Tuscany Registry of Sirolimus for Unselected In-Stent Restenosis) registry at 4 years. Journal of the American College of Cardiology. 2010;55:613.
- Lopez JJ, et al. Rapid adoption of drug-eluting stents: Clinical practices and outcomes from the early drug-eluting stent era. American Heart Journal. 2010;160:767.