Long-term antiplatelet therapy after coronary artery stenting in stable patients
- Donald Cutlip, MD
Donald Cutlip, MD
- Section Editor — Interventional Cardiology
- Professor of Medicine
- Harvard Medical School
- Beth Israel Deaconess Medical Center
- Jose C Nicolau, MD, PhD, FACC
Jose C Nicolau, MD, PhD, FACC
- Professor of Medicine
- University of Sao Paulo Medical School
- Section Editors
- Christopher P Cannon, MD
Christopher P Cannon, MD
- Section Editor — Coronary Heart Disease
- Professor of Medicine
- Harvard Medical School
- Stephan Windecker, MD
Stephan Windecker, MD
- Section Editor — Coronary Heart Disease
- Professor of Medicine
- Department of Cardiology
- Bern University Hospital
In patients with obstructive coronary artery disease who undergo percutaneous coronary intervention (PCI) to improve symptoms, stents, and in particular drug-eluting stents (DES), are used in the majority. There are some countries and regions where bare metal stents (BMS) are used more commonly.
Stent thrombosis is an uncommon but serious complication of coronary artery stenting that often presents as death and is almost always accompanied by myocardial infarction (MI), usually with ST-segment elevation. (See "Coronary artery stent thrombosis: Incidence and risk factors", section on 'Definitions'.)
Long-term dual antiplatelet therapy (DAPT; aspirin plus platelet P2Y12 receptor blocker) significantly lowers the risk of stent thrombosis. In addition, there is some evidence to support the idea that it also prevents ischemic events remote from the stented area.
This topic will discuss the use of antiplatelet therapy to reduce the risk of adverse outcomes after PCI in patients with stable coronary artery disease. Related topics include:To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- OUR APPROACH TO TREATMENT DURATION
- Drug-eluting stents
- - Bioresorbable polymer drug-eluting stents
- Bare metal stents
- Bleeding risk
- Decision tools
- AGENT AND DOSE
- SPECIFIC PATIENT GROUPS
- Patients not likely to comply
- Patients taking anticoagulants
- Patients needing temporary discontinuation
- - Noncardiac surgery or gastrointestinal endoscopy
- PREVENTION OF TREATMENT FAILURE
- Clopidogrel resistance/nonresponse
- RECOMMENDATIONS OF OTHERS
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS