Plavix therapy
Common Questions and Answers about Plavix therapy
plavix
Aspirin and Plavix (dual therapy) is recommended up to about a year after a stent(s) implant to help prevent any clots from forming at the site of the implant. Circumstances may exist that continued plavix medication may be prescribed for longer periods of time.
Structual collapse of a stent would indicate an improper size or defect. I discontinued plavix after year, and I have never heard of plavix associated with a collapsed stent! There may be a misunderstanding.
I am not aware of any new studies, but it has been the general consenus of the medical community for dual therapy (aspirin and plavix) up to about a year with drug eluding stents. A DES has some probability to cause restenosis up to about a year, after that period of time the probility decreases.
Seven years ago I had a DES implant and was on dual therapy for a year and discontinued. However, I have read some doctors chose to dual therapy if there has been a prior heart attack!?
Lately, there have many posts related to the duration of plavix and it seems patients are given plavix for a long period of time. It has been my understanding from what I have read and my experience, plavix is recommended for individuals that have a drug eluding stent to help prevent clots for up to a year. That has been my experience.
DES when compared to bare metal stent implants have an increase of clots and restenosis for a period of one year...
The Gastric Bypass requires me to be off of Plavix for 7-14 days. My cardiologist is opposed to discontinuation of platelet therapy for a short time in order to have a proceddure. I want to know why it is recommended to remain on plavix for a minimum of 12 months after the stent? Does the risk of thormbosis decrease so significantly at 12 months that it is worth the risk of another Major Cardiac Event?
If you’ve already had a heart attack or stroke or are resistant to the beneficial effects of aspirin, your doctor may suggest supplementary aspirin therapy with another clot-preventing drug, such as clopidogrel (Plavix). Clopidogrel may even be suggested as an alternative drug therapy, particularly if you’re allergic to aspirin or can’t tolerate its side effects."
Maybe someone will be able to add a thought or 2. Take care and keep us posted.
Plavix is not recommended for long term anti-platelet therapy. In fact it is not recommended for bare metal stent...up to about a year with drug eluding stents. There is a high risk for excessive bleeding, and that risk according what I read with your post was unnecessary.
Most doctors medicate with aspirin only as an anti-platelet drug. You should see another cardiologist as there is absolutely no evidence to support long term therapy with plavix.
t have as it pertains to restenosis with drug eluding stents. Then the regimen of choice is dual therapy of aspirin and plavix for about a year and then aspirin alone.
Do you have a specific condition that requires all the blood thinning medication? I take a baby coated aspirin, and bleed for several hours after a dental procedure, It is not typical for that much anti-platelet...high risk for internal bleeding; hit head you could bleed to death rather having a minor injury.
ve seen all kinds of reports about how stopping aspirin therapy cold turkey can lead to other issues. What are my risks and is there an effective way to wean off of aspirin other than just stopping?
Thanks very much.
It is generally agreed by the medical community that plavix and aspirin therapy for about a year post drug eluded stent implant. Then aspirin continuously. The dual therapy related to DES is recommended because the DES implant have a higher restenesis (clots) risk for about a year compared to the bare metal stents. Dual therapy (plavix) increases the risk of major bleeding.
The CURE study provides the evidence.
There is a much greater risk of bleeding on triple anticoagulant therapy as opposed to dual therapy. If you are bruising that easily with warfarin, clopidogrel(plavix) and aspirin, then I think your cardiologist is probably suggesting a wise change in your medication. Warfarin is a powerful anticoagulant and I think your stents should be fine with withdrawal of the plavix. The main concern here is obviously an internal bleed which can be life threatening.
The recommended treatment for DES implants is dual therapy of aspirin and plavix up to a year. Combining plavix and aspirin increases the risk of bleeding vs. aspirin alone in patients treated for more than a brief period of time. That is the regimen followed for my DES implant.
f you are in this category a prior MI and unstable angina:" In the CAPRIE trial, clopidogrel (plavix) was equivalent to aspirin for patients with a recent (but not acute) MI.
It is generally accepted proper therapy for stent implant patients to be on a regimen of plavix and aspirin for about a year as it appears drug eluding stents have tendancy to form clots. The ACC and AHA guidelines recommend not to be on plavix any longer than necessary as the risk out weighs any benefit. Aspirin indefinitely.
There may be exceptions, but I am not aware of any.
In an extraordinary hearing of the FDA in late 2006, the recommendation was to continue Plavix therapy for at least 12 months after DES. But recognizing that there was little data on which to base this recommendation, a strong plea was made to conduct a randomized clinical trial as rapidly as possible to answer the Plavix question once and for all.
As a nurse, I have given out so much Plavix and I cannot recall anyone experiencing MDS after Plavix therapy; that is my experience. I do know MDS is highly linked to benzene, xylene, radiation, certain chemotherapies, agent orange exposures and genetic mutation.
MDS has a 30-40% chance of converting to AML.
m guessing that you have significant bruising from both the aspirin and plavix therapy. I had commercial salmon trollers for fifteen years not too far from you, and believe you have to have had a lot of bruising caused by the type of work you do. I remember well being beat up by the wave action and the hard physical labor, I'd certainly talk to the doc about that, your arms and fingers have to be taking quite a beating.
Are they using bare metal stents rather than drug eluting stents? with DES and taking plavix, restenosis is very rare.
At the beginning after a stent implant there are antiplatet therapy with both aspirin and plavix (both have different mechanisms) to prevent clots. And at this time the risk is higher for blood clots and that can cause an MI.
After a stent is placed in a blood vessel, new tissue grows inside the stent, covering the struts of the stent. At the beginning this new tissue consists of healthy cells from the lining of the arterial wall (special cells...endothelium).
Severe joint and back pain usually is not a side effect of Plavix. Coumadin is more powerful than Plavix. The Plavix is important to take especially if you have coated stents. You may want to be checked for arthritis that may be flaring up. Coumadin is not to be used in persons with high cholesterol.
The usual protocol for the drug eluding stents is dual therapy of aspirin and plavix for a year. The reason for plavix is that DES has a tendency to clot when compared to bare metal stents, and less a problem for restenosis (overgrowth of tissue within the lumen). After a year medical consensus is to discontinue plavix as there is less risk for clots, but continue with aspirin for a lifetime.
There may be some individuals that have a higher risk for clots so plavix may continued indefinitely.
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