Stent users need blood thinners

Heart patients who have drug-coated stents inserted to prop open blocked coronary arteries should stay on anti-clotting drugs for at least a year, several doctor groups said in an advisory issued last week.

Drug-coated stents are often chosen over bare metal stents because they slowly release medication that reduces the chance of arteries reclogging, which can mean follow-up surgery. However, the newer stents mean a small but significant increased risk of clotting.

The new advisory -- issued by the American Heart Assn., American College of Cardiology, Society for Cardiovascular Angiography and Interventions, American College of Surgeons and the American Dental Assn. -- cited research showing blood clots in up to 29% of patients who stopped anti-clotting drugs early after receiving a drug-coated stent. The doctors also cited a study of 500 patients who received the drug-coated stents after a heart attack in which the death rate over the next 11 months was 7.5% for those who stopped taking anti-clotting medication compared with 0.7% for those who continued the regimen.

The new information means that before stent surgery, doctors must discuss with the patient whether there’s any reason they might not be able to keep up the drug regimen for a year.