JACC
HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
QUICK SEARCH:   [advanced]


     

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
This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
j.jacc.2007.01.003v1
49/6/734    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Grines, C. L.
Right arrow Articles by Whitlow, P.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Grines, C. L.
Right arrow Articles by Whitlow, P.

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
Top
 Abstract
 
ABSTRACT: Dual antiplatelet therapy with aspirin and a thienopyridine has been shown to reduce cardiac events after coronary stenting. However, many patients and healthcare providers prematurely discontinue dual antiplatelet therapy, which greatly increases the risk of stent thrombosis, myocardial infarction, and death. This advisory stresses the importance of 12 months of dual antiplatelet therapy after placement of a drug-eluting stent and educating the patient and healthcare providers about hazards of premature discontinuation. It also recommends postponing elective surgery for 1 year, and if surgery cannot be deferred, considering the continuation of aspirin during the perioperative period in high-risk patients with drug-eluting stents.

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


   Footnotes
 
The American Heart Association, the American College of Cardiology, the Society for Cardiovascular Angiography and Interventions, the American College of Surgeons, and the American Dental Association make every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.

This statement was approved by the American Heart Association Science Advisory and Coordinating Committee on December 21, 2006, by the American College of Cardiology on December 28, 2006, by the Society for Cardiovascular Angiography and Interventions on December 20, 2006, by the American College of Surgeons on December 16, 2006, and by the American Dental Association on December 17, 2006.

When citing this document, the American College of Cardiology Foundation requests that the following citation format be used: Grines C, Bonow RO, Casey DE, Jr., Gardner TJ, Lockhart PB, Moliterno DJ, O’Gara P, Whitlow P. 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. J Am Coll Cardiol 2007:49;xxx–xxx.

This article has been copublished with the American Heart Association and the Society for Cardiovascular Angiography and Interventions.

Copies: This document is available on the World Wide Web sites of the the American College of Cardiology (www.acc.org), American Heart Association (www.americanheart.org), and the Society for Cardiovascular Angiography and Interventions (www.scai.org). A single reprint is available by calling 800-242-8721 (US only) or writing the American Heart Association, Public Information, 7272 Greenville Ave, Dallas, TX 75231-4596. Ask for reprint No. 71-0395. To purchase additional reprints: Up to 999 copies, call 800-611-6083 (US only) or fax 413-665-2671; 1000 or more copies, call 410-528-4121, fax 410-528-4264, or e-mail kelle.ramsay{at}wolterskluwer.com.

Permissions: Multiple copies, modification, alteration, enhancement, and/or distribution of this document are not permitted without the express permission of the American Heart Association. Instructions for obtaining permission are located at http://www.americanheart.org/presenter.jhtml?Identifier=4431. A link to the "Permission Request Form" appears on the right side of the page.

* Representation does not imply endorsement by the American College of Physicians. Back




This article has been cited by other articles:


Home page
 J Am Coll CardiolHome page
S. R. Dixon, C. L. Grines, and W. W. O'Neill
The year in interventional cardiology.
J. Am. Coll. Cardiol., June 17, 2008; 51(24): 2355 - 2369.
[Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
S.-H. Choi, A. Prasad, and S. Tsimikas
The evolution of thienopyridine therapy clopidogrel duration, diabetes, and drug-eluting stents.
J. Am. Coll. Cardiol., June 10, 2008; 51(23): 2228 - 2229.
[Full Text] [PDF]

Home page
 CirculationHome page
P. Collins, C. M. Webb, C. F. Chong, N. E. Moat, and for the Radial Artery Versus Saphenous Vein Patenc
Radial Artery Versus Saphenous Vein Patency Randomized Trial: Five-Year Angiographic Follow-Up
Circulation, June 3, 2008; 117(22): 2859 - 2864.
[Abstract] [Full Text] [PDF]

Home page
 Therapeutic Advances in Cardiovascular DiseaseHome page
S. Jimenez-Valero, R. Moreno, A. Sanchez-Recalde, G. Galeote, L. Calvo, A. Viana, E. Lopez de Sa, and J. Lopez-Sendon
Review: Avoiding restenosis: is there a role for glucocorticoids in the drug-eluting stent era?
Therapeutic Advances in Cardiovascular Disease, June 1, 2008; 2(3): 137 - 146.
[Abstract] [PDF]

Home page
 ChestHome page
J. D. Douketis, P. B. Berger, A. S. Dunn, A. K. Jaffer, A. C. Spyropoulos, R. C. Becker, and J. Ansell
The Perioperative Management of Antithrombotic Therapy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition)
Chest, June 1, 2008; 133(6_suppl): 299S - 339S.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
E. M. Antman, S. D. Wiviott, S. A. Murphy, J. Voitk, Y. Hasin, P. Widimsky, H. Chandna, W. Macias, C. H. McCabe, and E. Braunwald
Early and Late Benefits of Prasugrel in Patients With Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention: A TRITON-TIMI 38 (TRial to Assess Improvement in Therapeutic Outcomes by Optimizing Platelet InhibitioN with Prasugrel-Thrombolysis In Myocardial Infarction) Analysis
J. Am. Coll. Cardiol., May 27, 2008; 51(21): 2028 - 2033.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll Cardiol IntvHome page
C. L. Grines, J. A. Goldstein, and R. D. Safian
Should We Routinely Use Drug-Eluting Stents for Acute Myocardial Infarction?: Let's Wait and See
J. Am. Coll. Cardiol. Intv., April 1, 2008; 1(2): 136 - 138.
[Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
D. P. Taggart, S. Kaul, W. E. Boden, T. B. Ferguson Jr, R. A. Guyton, M. J. Mack, P. T. Sergeant, R. J. Shemin, P. K. Smith, and S. Yusuf
Revascularization for unprotected left main stem coronary artery stenosis stenting or surgery.
J. Am. Coll. Cardiol., March 4, 2008; 51(9): 885 - 892.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
R. J. Applegate, M. T. Sacrinty, M. A. Kutcher, R. M. Santos, S. K. Gandhi, T. T. Baki, and W. C. Little
"Off-label" stent therapy 2-year comparison of drug-eluting versus bare-metal stents.
J. Am. Coll. Cardiol., February 12, 2008; 51(6): 607 - 614.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
C. L. Grines
Off-label use of drug-eluting stents putting it in perspective.
J. Am. Coll. Cardiol., February 12, 2008; 51(6): 615 - 617.
[Full Text] [PDF]

Home page
 J Am Coll Cardiol IntvHome page
R. Rogacka, A. Chieffo, I. Michev, F. Airoldi, A. Latib, J. Cosgrave, M. Montorfano, M. Carlino, G. M. Sangiorgi, A. Castelli, et al.
Dual Antiplatelet Therapy After Percutaneous Coronary Intervention With Stent Implantation in Patients Taking Chronic Oral Anticoagulation
J. Am. Coll. Cardiol. Intv., February 1, 2008; 1(1): 56 - 61.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
American College of Cardiology/American Heart Asso, 2007 Writing Group to Review New Evidence and Upda, S. B. King III, S. C. Smith Jr, J. W. Hirshfeld Jr, A. K. Jacobs, D. A. Morrison, and D. O. Williams
2007 Focused Update of the ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention
J. Am. Coll. Cardiol., January 15, 2008; 51(2): 172 - 209.
[Full Text] [PDF]

Home page
 CirculationHome page
S. B. King III, S. C. Smith Jr, J. W. Hirshfeld Jr, A. K. Jacobs, D. A. Morrison, D. O. Williams, 2005 WRITING COMMITTEE MEMBERS, S. C. Smith Jr, T. E. Feldman, J. W. Hirshfeld Jr, et al.
2007 Focused Update of the ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines: 2007 Writing Group to Review New Evidence and Update the ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention, Writing on Behalf of the 2005 Writing Committee
Circulation, January 15, 2008; 117(2): 261 - 295.
[Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
K. F. von Tiehl, M. J. Price, R. Valencia, K. J. Ludington, P. S. Teirstein, and R. A. Simon
Clopidogrel Desensitization After Drug-Eluting Stent Placement
J. Am. Coll. Cardiol., November 20, 2007; 50(21): 2039 - 2043.
[Abstract] [Full Text] [PDF]

Home page
 JAMAHome page
E. C. Nemergut, K. E. Littlewood, and D. G. de Souza
Preoperative Hematocrit Levels and Outcomes After Noncardiac Surgery
JAMA, October 3, 2007; 298(13): 1512 - 1513.
[Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
A. Schomig, A. Dibra, S. Windecker, J. Mehilli, J. Suarez de Lezo, C. Kaiser, S.-J. Park, J.-J. Goy, J.-H. Lee, E. Di Lorenzo, et al.
A Meta-Analysis of 16 Randomized Trials of Sirolimus-Eluting Stents Versus Paclitaxel-Eluting Stents in Patients With Coronary Artery Disease
J. Am. Coll. Cardiol., October 2, 2007; 50(14): 1373 - 1380.
[Abstract] [Full Text] [PDF]

Home page
 Br J AnaesthHome page
P.-G. Chassot, A. Delabays, and D. R. Spahn
Perioperative antiplatelet therapy: the case for continuing therapy in patients at risk of myocardial infarction
Br. J. Anaesth., September 1, 2007; 99(3): 316 - 328.
[Abstract] [Full Text] [PDF]

Home page
 ANN INTERN MEDHome page
S. L. Cohn and G. W. Smetana
Update in Perioperative Medicine
Ann Intern Med, August 21, 2007; 147(4): 263 - 270.
[Full Text] [PDF]

Home page
 Eur Heart J SupplHome page
C. Bode and M. Zehender
The use of antiplatelet agents following percutaneous coronary intervention: focus on late stent thrombosis
Eur. Heart J. Suppl., August 1, 2007; 9(suppl_D): D10 - D19.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
P. Vermeersch, P. Agostoni, S. Verheye, P. Van den Heuvel, C. Convens, F. Van den Branden, G. Van Langenhove, and DELAYED RRISC (Death and Events at Long-term follo
Increased Late Mortality After Sirolimus-Eluting Stents Versus Bare-Metal Stents in Diseased Saphenous Vein Grafts: Results From the Randomized DELAYED RRISC Trial
J. Am. Coll. Cardiol., July 17, 2007; 50(3): 261 - 267.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
A. Kastrati and A. Schomig
Drug-Eluting Stents: Is Their Future as Bright as Their Past?
J. Am. Coll. Cardiol., July 10, 2007; 50(2): 146 - 148.
[Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
R. Jaffe and B. H. Strauss
Late and Very Late Thrombosis of Drug-Eluting Stents: Evolving Concepts and Perspectives
J. Am. Coll. Cardiol., July 10, 2007; 50(2): 119 - 127.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
D. R. Holmes Jr, D. J. Kereiakes, W. K. Laskey, A. Colombo, S. G. Ellis, T. D. Henry, J. J. Popma, P. W.J.C. Serruys, T. Kimura, D. O. Williams, et al.
Thrombosis and Drug-Eluting Stents: An Objective Appraisal
J. Am. Coll. Cardiol., July 10, 2007; 50(2): 109 - 118.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
E. S. Brilakis, S. Banerjee, and P. B. Berger
Perioperative Management of Patients With Coronary Stents
J. Am. Coll. Cardiol., June 5, 2007; 49(22): 2145 - 2150.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
J. T. Dove, D. J. Moliterno, W. D. Weaver, and M. E. Shelton
President's Page: Drug-Eluting Stents in Contemporary Practice--A Call for a Real-World, Open-Entry, Device-Tracking Registry
J. Am. Coll. Cardiol., June 5, 2007; 49(22): 2223 - 2226.
[Full Text] [PDF]

Home page
 BMJHome page
D. P Taggart
Coronary revascularisation
BMJ, March 24, 2007; 334(7594): 593 - 594.
[Full Text] [PDF]

This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
j.jacc.2007.01.003v1
49/6/734    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Grines, C. L.
Right arrow Articles by Whitlow, P.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Grines, C. L.
Right arrow Articles by Whitlow, P.

HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK