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Clopidogrel, sold under the brand name Plavix among others, is an antiplatelet medication used to reduce the risk of heart disease and stroke in those at high risk. [10] It is also used together with aspirin in heart attacks and following the placement of a coronary artery stent ( dual antiplatelet therapy ). [ 10 ]
Other anticoagulant medicines are also used and the long term combination of aspirin and plavix is a typical post stenting strategy. For patients undergoing PCI after a heart attack extended stays are very dependent on the degree of damage caused by the event. [18] [19]
Clopidogrel affects the ADP-dependent activation of IIb/IIIa ... (90 days) after a coronary stent is placed if postponing surgery any longer would result in ...
Based on early trials, the advised antiplatelet regimen for drug-eluting stents was a combination of aspirin and clopidogrel for 3 months when Cypher stents were used, [36] and 9 months when Taxus stents were used, [55] followed by aspirin indefinitely. Soon, case reports started being published regarding late stent thrombosis. [56]
A drug-eluting stent (DES) is a small mesh tube that is placed in the arteries to keep them open in the treatment of vascular disease.The stent slowly releases a drug to block cell proliferation (a biological process of cell growth and division), thus preventing the arterial narrowing that can occur after stent implantation.
While the use of intracoronary stents do not improve the short term outcomes in primary PCI, the use of stents is widespread because of the decreased rates of procedures to treat restenosis compared to balloon angioplasty. [30] Adjuvant therapy during an angioplasty includes intravenous heparin, aspirin, and clopidogrel.
In those who have had a stent, more than 12 months of clopidogrel plus aspirin does not affect the risk of death. [ 111 ] Beta blocker therapy such as metoprolol or carvedilol is recommended to be started within 24 hours, provided there is no acute heart failure or heart block .
After placement of a stent or scaffold, the patient needs to take two antiplatelet medications (aspirin and one of a few other options) for several months to help prevent blood clots. The length of time a patient needs to be on dual antiplatelet therapy is individualized based risks of ischemic events and bleeding risk.