Prevention of Premature Discontinuation of Dual Antiplatelet Therapy in Patients With Coronary Artery Stents: A Science Advisory From the American Heart Association, American College of Cardiology, Society for Cardiovascular Angiography and Interventions, American College of Surgeons, and American Dental Association, With Representation From the American College of Physicians

doi:10.1016/j.jacc.2007.01.003

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J Am Coll Cardiol, 2007; 49:734-739, doi:10.1016/j.jacc.2007.01.003 (Published online 17 January 2007).
© 2007 by the American College of Cardiology Foundation

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AHA/ACC/SCAI/ACS/ADA SCIENCE ADVISORY

Prevention of Premature Discontinuation of Dual Antiplatelet Therapy in Patients With Coronary Artery Stents

A Science Advisory From the American Heart Association, American College of Cardiology, Society for Cardiovascular Angiography and Interventions, American College of Surgeons, and American Dental Association, With Representation From the American College of Physicians^_*

Cindy L. Grines, MD, FACC, Robert O. Bonow, MD, FAHA, FACC, Donald E. Casey, Jr, MD, MPH, MBA, FACP, Timothy J. Gardner, MD, FAHA, FACC, FACS, Peter B. Lockhart, DDS, FDS RCSEd, David J. Moliterno, MD, FAHA, FSCAI, FACC, Patrick O'Gara, MD, FAHA, FACC and Patrick Whitlow, MD, FAHA, FACC

Abstract: Dual antiplatelet therapy with aspirin and a thienopyridinehas been shown to reduce cardiac events after coronary stenting.However, many patients and healthcare providers prematurelydiscontinue dual antiplatelet therapy, which greatly increasesthe risk of stent thrombosis, myocardial infarction, and death.This advisory stresses the importance of 12 months of dual antiplatelettherapy after placement of a drug-eluting stent and educatingthe patient and healthcare providers about hazards of prematurediscontinuation. It also recommends postponing elective surgeryfor 1 year, and if surgery cannot be deferred, considering thecontinuation of aspirin during the perioperative period in high-riskpatients with drug-eluting stents.

Key Words: AHA Scientific Statements • thrombosis • myocardial infarction • stents • myocardial stunning

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