A Hearty Life

Have a Coated Stent? Stay On Plavix

by Hsien-Hsien Lei, PhD on December 6th, 2006

Stents for opening clogged arteries are one of the greatest breakthroughs of cardiovascular medicine. Unfortunately, the recent increase in the use of coated (drug-eluting) stents has created a new problem.

If patients discontinue anti-clotting medication, usually Plavix, they experience a higher risk of late-stent thrombosis (clotting). Researchers conclude that those patients who can’t afford to stay on the high-cost Plavix regimen longer than three or six months or who have other conditions which will require them to discontinue the drug should not receive a coated stent.

The other alternative is to use bare metal stents which carry their own risks of restenosis where scar tissue accumulates around the stent thus narrowing the artery and causing chest pain. Surgery is sometimes needed if scarring is too severe.

Recent studies on coated stents (Los Angeles Times):

• Last week, researchers from the Cleveland Clinic reported in the American Journal of Medicine that clots were four to five times more likely to occur with coated stents than with the bare-metal variety.
• Swiss researchers reported in the Journal of the American College of Cardiology on Monday that patients who stopped taking Plavix doubled their risk of heart attack or death compared with patients with bare-metal stents.
• In the latest study, researchers at Duke University looked at 1,500 patients who received coated stents, comparing those who discontinued Plavix with others who stayed on the drug for at least six months. After two years, those taking Plavix had a death or heart attack rate of three per 100, compared with seven per 100 for those no longer taking the anti-clotting drug, researchers said.
• Researchers at Duke also looked at more than 3,100 patients who had received a bare-metal stent. After two years, the rate of heart attack or death among patients with bare-metal stents was more than five per 100 — worse than the coated stent patients who stayed on Plavix but better than those with coated stents who stopped the drugs.

If you have a coated stent, I would highly encourage you to bring the results of these studies to your doctor’s attention.

Technorati Tags: stents, coated stents, drug-eluting stents, cardiology, heart, heart disease, cardiovascular disease, angioplasty, plavix, thrombosis, restenosis

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