Taking Plavix After Stent Implant

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Taking Plavix After Stent Implant

Question:

I had a heart attack 13 months ago and had two bare metal stents inserted. Plavix was prescribed. How long should I take this medicine? Is it really beneficial when taken with aspirin?

Answer:

Clopidogrel, which is sold under the brand name Plavix, should be taken for at least one month after the implantation of bare metal stents. Blood exposed to the metal is more likely to clot inside the stent.

Plavix is taken along with aspirin. This gives your body time to coat the new "hardware" inside your coronary arteries with your own cells. After a month, the Plavix can be stopped because the clotting risk is not as high.

People who receive stents that are coated with medication need longer courses of clopidogrel, because it takes much longer for cells to cover their stents.

If your only reason for still taking Plavix is the stents, then you have certainly been taking this drug long enough. But your doctor may have other reasons for wanting you to continue on both aspirin and Plavix. Plavix is so good at stopping blood clots from forming that many doctors advise patients to continue it for a year or more, as long as patients are not having bleeding problems or any other side effects.

There are two good reasons, though, not to continue Plavix forever. One is the expense, which is not trivial. The second is that you have a higher risk of bleeding. For example, emergency operations would be more risky while you are on this drug.

In short, I think you and your doctor should have a discussion at this point about whether you really need to stay on it.

Thomas Lee, M.D., is the chief executive officer for Partners Community HealthCare Inc. He is a professor of medicine at Harvard Medical School. He is an internist and cardiologist at Brigham and Women's Hospital. Dr. Lee is the chairman of the Cardiovascular Measurement Assessment Panel of the National Committee for Quality Assurance.

Last updated:	July 20, 2009