Year of taking risky blood thinners may be unnecessary after stent surgery

September 20, 2012 by Maureen Salamon, Healthday Reporter
Year of taking risky blood thinners may be unnecessary after stent surgery
Studies suggest it might be safe to stop double anti-platelet therapy sooner.

(HealthDay)—A full year of aggressive anti-clotting therapy—which can lead to heavy bleeding—may not be needed after surgery to implant a drug-coated cardiac stent, two new studies suggest.

Standard treatment for patients receiving so-called drug-eluting , which prop open after angioplasty, typically entails 12 months of double anti-platelet therapy consisting of aspirin and prescription . Korean and Spanish research indicates, however, that patients who discontinue such risky therapy after several months suffer no more ill effects than those treated for a year.

"The interesting thing is, we went through a period of time so panicked about anti-platelet therapy interruptions and the effect they might have," said Dr. Kirk Garratt, director of clinical research at Lenox Hill Heart and Vascular Institute of New York City, who was not involved in the studies. "But over the last few years, a series of reports and clinical trials say the same thing—that we probably don't need to be as worked up about it as we used to be."

The studies are scheduled for publication Sept. 21 in the Journal of the American College of Cardiology.

Cardiac stents— tubes that prevent from re-closing—are implanted in more than 500,000 Americans each year, according to the U.S. . Some stents are coated with slowly released medication to prevent the growth of in the artery lining.

Prescription blood thinners used in double anti-platelet therapy, such as () and warfarin (Coumadin), are tricky to dose properly and can lead to life-threatening bleeding complications.

The Korean study split more than 2,100 patients, all of whom underwent stent surgery after angina (chest pain) or a heart attack, into groups treated with either three months of double anti-platelet therapy or the standard 12-month course. After a year, just less than 5 percent of both groups had suffered complications such as death, bleeding, heart attack or clotting near the stent.

The Spanish study addressed interruptions in double anti-platelet therapy due to noncompliance, surgery or other medical decisions in a group of 1,600 patients. Most of the 10.6 percent of patients who discontinued the therapy did so temporarily, but this practice didn't translate into more serious consequences compared to those whose therapy was not interrupted.

"The big takeaway is that neither of these studies fundamentally change the way I think about these therapies for my patients," Garratt said. "But the Spanish study increases my confidence in the way I'm managing these patients."

But Dr. Christopher Cove, associate professor of medicine and assistant director of the cardiac catheterization lab at University of Rochester Medical Center in New York, cautioned it would be a mistake to think it's safe to stop double anti-platelet therapy based on the new research. Larger studies are needed, he added.

"We know that [double anti-platelet therapy] is beneficial as compared to aspirin alone in large groups of patients, and that there's a high risk of bleeding with it," Cove said. "What we really need to know is, if we have to stop double anti-platelet therapy, when is the safe time to do that."

Explore further: 3-drug regimen equal to double-dose 2-drug approach in preventing clots after angioplasty

More information: The American Heart Association has more about angioplasty and stents.

Related Stories

3-drug regimen equal to double-dose 2-drug approach in preventing clots after angioplasty

March 26, 2012
In a comparison of drugs to prevent blood clots after angioplasty, a three-drug regimen favored in Asia to increase anti-clotting effect was found to be as safe and effective as a double-dose two-drug treatment commonly used ...

New class of platelet blockers proves effective in phase III trial

March 26, 2012
Adding vorapaxar, an investigational platelet blocker, to standard antiplatelet therapy significantly reduces the risk of recurrent cardiovascular events in patients with known atherosclerosis, a hardening and narrowing of ...

Novel anti-platelet therapy reduces risk of cardiac events in patients with history of heart attack

August 27, 2012
According to new research from Brigham and Women's Hospital (BWH), adding vorapaxar, an investigational platelet blocker, to standard antiplatelet therapy significantly reduces the long-term risk of recurrent cardiovascular ...

Lower achieved platelet reactivity associated with better cardiovascular

August 30, 2011
Compared to patients who had persistently high platelet reactivity, those who achieved low platelet reactivity, according to the VerifyNow P2Y12 Test, had a reduced incidence of cardiovascular death, heart attack and stent ...

Antiplatelets: 1 person, 1 dose?

April 14, 2011
An international consortium of scientists, including major contributions from the Montreal Heart Institute, demonstrates that the "one-size fits all" strategy of uniformly doubling the dose of an antiplatelet drug, clopidogrel, ...

Recommended for you

Could this protein protect people against coronary artery disease?

November 17, 2017
The buildup of plaque in the heart's arteries is an unfortunate part of aging. But by studying the genetic makeup of people who maintain clear arteries into old age, researchers led by UNC's Jonathan Schisler, PhD, have identified ...

Raising 'good' cholesterol fails to protect against heart disease

November 16, 2017
Raising so-called 'good' cholesterol by blocking a key protein involved in its metabolism does not protect against heart disease or stroke, according to a large genetic study of 150,000 Chinese adults published in the journal ...

New model estimates odds of events that trigger sudden cardiac death

November 16, 2017
A new computational model of heart tissue allows researchers to estimate the probability of rare heartbeat irregularities that can cause sudden cardiac death. The model, developed by Mark Walker and colleagues from Johns ...

Popular e-cigarette liquid flavorings may change, damage heart muscle cells

November 16, 2017
Chemicals used to make some popular e-cigarette liquid flavorings—including cinnamon, clove, citrus and floral—may cause changes or damage to heart muscle cells, new research indicates.

Possible use for botulinum toxin to treat atrial fibrillation

November 16, 2017
From temporarily softening wrinkles to easing migraines, botulinum toxin has become a versatile medical remedy because of its ability to block nerve signals that can become bothersome or risky.

Proteome of the human heart mapped for the first time

November 15, 2017
A healthy heart beats about two billion times during a lifetime, thanks to the interplay of more than 10,000 proteins. Researchers from the Max Planck Institute of Biochemistry (MPIB) and the German Heart Centre at the Technical ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.