Why a coronary stent?
According to the Mayo Clinic Heart Book, Revised Edition: The Ultimate Guide to Heart Health, about 33% or more of blockages cleared by angioplasty (without a stent) re-block to their original severity in less than a year. Installing a cardiac stent at the time of angioplasty has been successful in reducing the re-narrowing rate to about 15%. Following heart stent placement, doctors generally prescribe aspirin and/or other medications to reduce the chance of clotting.
Drug eluting stents
Chemically coated or drug eluting stents have been used in recent years to further reduce the risk of re-blocking These stents have not been without controversy.
Studies have shown that drug eluting stents perform better than bare metal stents in preventing scar tissue from forming in the artery. In some people there's a small increased risk of blood clots forming in the stent once the drug coating has been used up — sometimes a year or more after stent implantation.
There are a number of potential explanations for blood clots developing later. It may be related to how long a person takes anti-platelet medications such as aspirin and/or clopidogrel (Plavix). If these medications are stopped earlier than recommended or if an individual doesn't have an effective response to the anti-clotting medications, there can be problems.
An American Food and Drug Administration (FDA) advisory panel found that when drug eluting stents are used for specific situations approved by the FDA — there was no increased risk of heart attack or death with drug eluting stents compared with bare-metal stents.
The FDA panel said when drug eluting stents are used in someone who has multiple blockages and other complications, there's a small but increased risk of blood clotting that can lead to heart attack and death. It's unknown if the drug-eluting stents cause this increased risk or whether people in this group tend to be at higher risk in the first place.
So what does this mean for you?
A cardiac stent (bare metal or drug-eluting) is a foreign object inside your body. Precautions have to be taken to prevent blood clots. Medications (aspirin and clopidogrel/Plavix) have been found to be extremely effective.
The Medical Journal of Australia suggests a longer duration of dual antiplatelet therapy (medication) may be beneficial, particularly if drug-eluting stents are used for more complex cases.
Don't stop your medications without consulting with your doctor.
Cindy Grines, M.D., a cardiologist at William Beaumont Hospital in Royal Oak, Michigan, says "We want to alert patients and health care professionals that this is a serious medical issue; they shouldn’t even think about stopping antiplatelet therapy because it could result in heart attack or death."
If you are allergic to aspirin or Plavix or are unable to take your medication because of bleeding or other problems, your doctor may recommend alternative medications (depending upon the problem).
Cardiac stents have been a lifesaver for many of us - and the technology continues to develop and improve.
According to mayoclinic.com, based on all presently available information, drug eluting stents are safe and effective in most circumstances. The key is you must take your medications in the prescribed manner and for the prescribed duration to help ensure your safety.
We'll publish updates if and when any new information becomes available.
If you have a cardiac stent, you still need to take action to reduce your risks.
If you have further questions about living with a cardiac stent, talk to your doctor. For additional information, check out the American Heart Association.
Here's an animated video that shows how a stent is inserted into your artery.