Plavix vs aspirin stent
Common Questions and Answers about Plavix vs aspirin stent
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.
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.
Plavix and aspirin for preventing stroke and other serious vascular events in high vascular risk patients. Up to one year after a stent implant, plavix and aspirin are the recommended protocol as statistics have shown a high risk for clot.
The anticoagulant coumadin and the antiplatelet agent aspirin have been shown to have similar benefits after myocardial infarction.
I had angioplasty in 2001 and had a stent implant. My cardiologist prescribed Plavix and 81 mg aspirin daily among the other medications (beta blocker, ACE inhibitor, statin). I have recently moved to a new city and have not found a new cardiologist yet but family physician suggested that Plavix could be discontinued as the guidelines have changed and no long recommended after 12 months post stent implant.
Suggestions please?
I have a drug eluting stent implanted in 2006. I have now been on Plavix and aspirin for over three years. The cardiologist says I will be on it for "life". If the use of Plavix and aspirin can be eliminated after 2 to 4 months of the implantation of a bare metal stent, why can't Plavix and aspirin be eliminated after a year? At what point does the drug eluting process stop so that the drug eluting stent becaomes the same as a bare metal stent?
Plavix has a unique mechanism of action by blocking the amplification of platelet activation by released ADP, and often used with aspirin to prevent the risk of clots for the first year after DES implant. Plavix and aspirin have different mechanism of action to prevent clots. After a year, plavix is usually discontinue as the risk for clots is decreased, and aspirin is continued long term. The risk of a clot is about 3%.
A normal artery lining is smoother than glass under a microscope, but a stent is very rough in texture, offering a great area for platelets to become active and form a clot. Plavix and aspirin should be used until a new artery lining grows through the stent mesh, creating a new 'smoother than glass' area. This can take up to 3 to 4 months and so a year of plavix is a safe guard. However, some people removed off plavix form clots quickly.
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.
Plavix has not been found to be any more effective than a low dose of aspirin for anti-platlet medication. However, the preferred protocol after drug eluding stent implant is a year or so with aspirin and plavix regimen for the treatment of the probability of restenosis (blood clots) at the site of the stent.
No anti-platlet medication can off set the deleterious effects of nicotine, and small vessels are especially vulnerable for blood flow problem.
The good doctor from expert forum states Plavix is unnecessary and aspirin is sufficient. After a stent implant my cardiologist put me on Plavix and aspirin for a year...then dropped Plavix and continued with aspirin. There is some evidence that Plavix helps prevent restenosis with a drug eluding stent up to about a year.
There is a risk of excessive bleeding and that should be serious consideration when on anti-platelet medication, and the benefit, if any, don't outweigh the risk.
I am not sure if the therapy would or wouldn't work without aspirin. I have never heard this before. I know it has been suggested I take Plavix and aspirin. I don't take the Plavix for personal reasons, and I always forget my aspirin. I did some goggling and found this bit in an article. It suggests that Plavix is an alternative. Not sure if that is correct or not.
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).
The generally accepted protocol for a drug eluding stent is plavix for a year or more with aspirin. Aspirin should be continued indefinitely.
There appears to be some problems with some individuals regarding restenosis with the DES. What is the underlying cause for the CHF? I assume it was ischemia (lack of blood flow) to heart cells, and that could be new blockages or partial blockages at the time of first event and has increased the blockage, arrhythmia, etc.
There is no medical published literature that supports excessive doses of an antiplatelet medication. I take 67mg aspirin and discontiued plavix a year after the stent implant 7 years ago. I have a totally occluded LAD, 70% occluded circumflex, and moderate to severe mitral valve regurgitation. I don't know why someone who has several stents is higher risk than someone who has had congested heart failure.
Are we giving enough clopidogrel and aspirin to prevent stent thrombosis? And as we know, there are different levels of IPAs (inhibition of platelet aggregation). that has been measured with patients who are taking clopidogrel, and..."
There are studies about aspirin resistance and plavix resistance and there are studies that say it's 20-40% of the population. Other studies, at least with aspirin, it's about less than 1% if you use the arachidonic acid based (testing).
I had plavix and aspirin for a year after stent implant, and now only aspirin. Both meds are anti-platelet agents, and many doctors go with both medication as they have different menchanisms for anti-clotting. The plavix is prescribed as it considered to be more effective against the formation of clots that appear to be a problem with drug eluding stents up to about a year. After a year or so aspirin only (87mg), as there is a risk of excessive bleeding with both agents.
After reading so many horror stories, I am concerned...I have been on Plavix for 4 years along with an 81 Mg aspirin. I think I will continue the aspirin...but this is day 3 and no problems thus far..
This discussion is related to <a href='/posts/show/254866'>Plavix dosing following drug eluting stents</a>.
I have a blockage somewhere in the area of the heart { lower descending anterior coronary artery region } I am an afib patient with high blood pressure, hypertension, diabetic, thyroid and bleeding from the rectum because of hemoroids and have recently failed my stress test and ordered to have an anteriogram in the stent room just in case... I also have a low blood count.
I did not get hit in any of those places. Did the 75mm Plavix plus two baby aspirin daily for 18 mos cause this and is it dangerous? The plavix was prescribed because I had a drug eluding stent ( 3 of them) placed in my LAD which was 90 % occluded. Can I reduce my plavix to half one or two days and drop the aspirin to see if the spots go away and no more start?
Thanks!
QUOTE: "There is a third artery, a large one, which the cardiologist says is, 'very diseased. If he stented this artery I have to take Plavix for a year. So he wasn't sure what to do".
An option would be an implant of a bare metal stent. The reason for the plavix after a drug eluding stent is the risk of a clot within a year. The risk isn't very high to have an implant with DES and a clot (I believe one percent for the risk).
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.
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