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What Medicines Do I Take After a Stent?

Posted Aug 24 2008 1:49pm
ANNOUNCER: A common question asked by people who have stents is why they need to continue taking drugs like Aspirin, Plavix or Coumadin.

SPENCER B. KING, III, MD: After stenting, the blood platelets—these are little particles within the blood that help us stop bleeding, if we cut, they collect and form a clot—those platelets can be detrimental after you have a stent placed. They can actually build up on the stent and may cause a clot to form there.

ADOLPH M. HUTTER, JR., MD: We need to use some drugs that prevent blood clots from forming in the stent or from restenosis. And the most effective drugs have been shown to be the antiplatelet drugs: That's Aspirin or clopidogrel, called Plavix. These are the anti-platelet drugs. They work very well.

Coumadin, which is a blood thinner against clots formed by thrombin doesn't work very well for stents. So you need to be on aspirin and Plavix, but you don't need to be on Coumadin just for a stent. You might need Coumadin for another reason, but you don't need it just because you have a stent.

SPENCER B. KING, III, MD: Coumadin is an anti-clotting drug that people know about, but it is not routinely used after stenting. It has different uses, in atrial fibrillation and in preventing clots in the legs and all sorts of things. But when stents are used, it's the combination of aspirin and the clopidogrel that is critical.

ANNOUNCER: Determining which drug a patient should use depends on the type of stent they have.

ADOLPH M. HUTTER, JR., MD: If you have a bare metal stent, then you should be on aspirin 325 mg/day, and Plavix 75 mg/day, for a month. If you have a drug-eluting stent, we know that those events can occur many, many months after a month, and so most people recommend that you be on aspirin 325 mg/day, and Plavix 75 mg/day indefinitely, at least for six months.

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