janeagers posted:
Hi. I had my first heart attack in 2001. I was put on the blood thinner plavix. I had 5 stints placed at that time. My cardiologist told me that I would be on plavix for the rest of my life. The stints were not drug-treated stints. I have had 3 more stints placed that are drug-treated and I had triple by-pass surgery in 2007. My question is do I still need to take plavix for the rest of my life. My current cardiologist says I do not need to continue but I feel I should take it. thank you for your response.
cardiostarusa1 responded:

It is typically 1 year of Plavix for drug-eluting stents (DES), though researchers say that continuing studies will prove or disprove a universal benefit beyond that. With the older bare-metal stents that are still being used, it is typically 1 month of Plavix.

Aspirin (at a dose that ones' cardiologist suggests) is sometimes added to the Plavix regimen, though it has a different mechanism of action, and can increase the risk of bleeding. Aspirin-alone may be applicable in some cases, and usually continues indefinitely after Plavix is stopped.

About Plavix

Plavix prevents platelets (a component of blood) from clumping together and causing a blood clot (thrombosis).

Platelets (thrombocytes), manufactured in the bone marrow, are small cells in the bloodstream that are part of the blood clotting process.

Plavix 'n Stents

Plavix-therapy is extremely important. As reported, early or late-stent thrombosis is the formation of a blood clot on the struts of a DES, occurring weeks, months, or even years, after implantation, which according to one study, leads to death about half the time.

DES delays a process known as endothelialization, in which a thin layer of cells gradually grows over and covers over the stent.

A study published in The Lancet, a prestigious medical journal, detailed 4 cases in which DES patients experienced a heart attack from stent thrombosis about a year after implantation, and shortly after stopping antiplatelet-therapy.

Studies have revealed that an increased potential for blood clot problems may continue on in some DES patients much longer than previously understood/realized, thus many interventional cardiologists are recommending Plavix for a year (or more), some indefinitely/for life, especially is one has had a heart attack or brain attack (stroke).

Bottom line

Coronary stents are just a Band-aid or spot treatment, and bypass is just a clever way to circumvent the problem, as this does not address the underlying disease process and what drives the progression.

Most important, coronary artery disease (CAD) is a life-long unpredictable (which can exhibit periods of stabilization, acceleration and even some regression) condition, requiring a continuum of care.

Take care,


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Be well-informed

From Dr. Beckerman

Plavix is typically recommended for one of two reasons:

1) You have just gotten a stent. Depending on the type of stent, Plavix is recommended in addition to aspirin for one month up to one year.

2) You have had a heart attack. There are studies that suggest a benefit to taking Plavix in addition to aspirin for one year after the heart attack.

Plavix is also sometimes recommended in cases of true aspirin allergies when aspirin would be recommended.

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Living with Coronary Artery Disease

A disease with no cure...

Coronary artery anatomy

Starting with the LAD, the most critical, next to the ultra-critical LM.


Good to know, for the primary/secondary prevention of heart attack/brain attack

Epidemiologic studies have revealed risk factors (encompasses new, novel or emerging) for atherosclerosis, typically affecting carotid, coronary, peripheral arteries, which includes age, gender, genetics, diabetes (considered as being the highest risk factor), smoking (includes second/thirdhand), inactivity, obesity, hypertension, Low HDL (now questionable, according to recent studies) high LDL, small, dense LDL, RLP (remnant lipoprotein), high Lp(a), high ApoB, high Lp-PLA2, high triglycerides, HDL2b, high homocysteine (now questionable), and high C-reactive protein (CRP/hs-CRP).



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