Anticoagulate for at least one year after drug-eluting stent is put in

December 17, 2007

PCI guideline update recommends long-term anticoagulation for DES

A guideline update from the American College of Cardiology, the American Heart Association, and the Society for Cardiovascular Angiography and Interventions recommends combination therapy with both aspirin and clopidogrel for at least a year, and possibly longer, following placement of a drug-eluting stent (DES). The update addresses findings from studies published through the end of 2006 that showed DES placement is associated with a slightly higher risk of clot formation. The guideline authors emphasize that prescribers should consider whether a patient is capable of being medication-compliant when choosing between a DES or a bare-metal stent. Future planned surgeries or other medical procedures where patients could not take the two anticoagulants should also be considered before stent placement. The guideline update also addresses timing of stent placement in certain groups of patients and emphasizes the importance of tobacco cessation, blood pressure control, and low cholesterol in the prevention of heart attacks. The "2007 Focused Update of the ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention can be accessed at