How Long do I Have to Take my Stent Medication?
New guidelines for duration of dual antiplatelet therapy in coronary artery disease patients
Written by Bryan Heart cardiologist John Steuter, MD
Patients receive cardiac stents to restore coronary blood flow, alleviate chest pain, and treat a heart attack. After stenting, patients receive dual antiplatelet therapy (DAPT). Since platelets are involved in the clotting process, patients must take dual antiplatelet therapy, which is a combination of Aspirin plus either Plavix, Brilinta or Prasugrel.
The duration of DAPT for patients who receive cardiac stents has been a topic of much debate for some time now. The timing of surgery (noncardiac or cardiac) for a patient was often affected and altered by this duration as these medications would need be held for bleeding risk.
The American College of Cardiology (ACC) and American Heart Association (AHA) guidelines recommended stable ischemic heart disease patients continue DAPT for:
- One year after placement of drug eluting stent
- Three months after bare metal stent
On March 29, 2016 the ACC/AHA release new updated guidelines about the duration of DAPT.
Stable ischemic heart disease patients continue DAPT for:
- Six months, at least, after placement of drug eluting stent
- One month, at least, after bare mental stent
Additional Guidelines for Continuation of DAPT
Acute coronary syndrome patients (NSTEMI and STMI)
- Remains one year
- This also applies specifically to duration of P2Y12 inhibitor therapy (i.e., Plavix, Prasugrel and Brilinta)
- Aspirin – continue indefinitely
For more information on DAPT guidelines and information, or to refer a patient to a Bryan Heart cardiologist or surgeon, please call 402-483-3333.