Author + information
- 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 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.
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;734–9.
This article has been copublished with the American Heart Association and the Society for Cardiovascular Angiography and Interventions.
Copies: For copies of this document, please contact Elsevier Inc. Reprint Department, fax (212) 633-3820, e-mail.
Permissions: 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.
- American College of Cardiology Foundation
- Dual Antiplatelet Therapy for Prevention of Ischemic Cardiovascular Events and Stent Thrombosis
- Premature Thienopyridine Discontinuation and Stent Thrombosis
- Stent Thrombosis After Noncardiac Surgery
- Factors Related to Premature Cessation of Thienopyridine Therapy
- Summary and Recommendations