Drug-eluting stents: Do they increase heart attack risk?
Drug-eluting stents: Do they increase heart attack risk?
The most common type of heart stent is generally considered safe and effective when used with anti-clotting medication.
A stent is a small mesh tube put into an artery to keep it open. A drug-eluting stent is coated with a slow-release medication to help prevent blood clots from forming in a stent.
Blood clotting in a stent can cause a future blockage (restenosis) and may lead to a heart attack.
Stents without a drug coating are called bare-metal stents.
Drug-eluting stent safety
Today, new and improved versions of drug-eluting stents are considered safe and effective for most people when used with anti-clotting medication as prescribed. In general, drug-eluting stents are less likely to cause restenosis than are bare-metal stents.
A drug-eluting stent is the most common type of stent used to treat a blockage of the heart arteries. Many people with heart problems have been successfully treated with drug-eluting stents, preventing the need for more-invasive procedures, such as coronary artery bypass surgery.
A heart doctor (cardiologist) places a stent during coronary angioplasty, also called percutaneous coronary intervention. In this procedure, a thin, flexible tube (catheter) with a balloon on the tip is put in a blood vessel. The balloon is temporarily inflated to widen the blocked artery and improve blood flow. Sometimes, a drug-coated balloon is used.
For chest pain due to a blocked heart artery, a drug-eluting stent can reduce the symptoms and prevent the need for repeat angioplasty procedures.
What to consider before getting a drug-eluting stent
A drug-eluting stent may not be an option for people with a history of bleeding problems. That’s because having the stent makes it necessary to take aspirin and a prescription blood thinner such as clopidogrel (Plavix) to prevent blood clotting in the stent. Having a drug-eluting stent might mean taking a daily aspirin for life.
A health care provider can give more instructions on what to expect before and after drug-eluting stent placement. Some things to consider are:
- Needing another type of surgery soon. A health care provider might recommend postponing other surgery not related to the heart (noncardiac surgery) for a year, if possible, after getting a drug-eluting stent. For those who can’t postpone surgery, a bare-metal stent may be a better option.
- Needing a change of medications. Blood thinners and aspirin can affect surgeries, some medical procedures and certain other medications. If a noncardiac surgery can’t be postponed, a health care provider might adjust the dosages of anti-clotting medications and aspirin. It also might be possible to stop taking anti-clotting medications six months after stent placement, but only with the approval of a care provider.
After getting a drug-eluting stent
After you’ve received a drug-eluting stent, a health care provider prescribes medications, such as aspirin and statins, and lifestyle changes to prevent stent or heart problems. Healthy lifestyle changes include stopping smoking, eating a more heart-healthy diet and getting plenty of exercise.
For some people, coronary bypass surgery may be done instead of stent placement. Coronary bypass surgery works well, but it’s more invasive than using stents, which means a longer recovery time.
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June 08, 2022
- Stents. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health-topics/stents. Accessed April 14, 2021.
- Cutlip D, et al. Drug eluting intracoronary stents: Stent types. https://www.uptodate.com/contents/search. Accessed April 14, 2021.
- Bonow RO, et al., eds. Percutaneous coronary intervention. In: Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Elsevier; 2019. https://www.clinicalkey.com. Accessed April 14, 2021.
- Cho S, et al. Long-term efficacy of extended dual antiplatelet therapy after left main coronary artery bifurcation stenting. The American Journal of Cardiology. 2020; doi:10.1016/j.amjcard.2019.10.046.
- Coronary heart disease. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health-topics/coronary-heart-disease. Accessed April 14, 2021.
- Min L, et al. Drug-coated balloon versus drug-eluting stent in de novo small coronary vessel disease: A systematic review and meta-analysis. Medicine. 2019; doi:10.1097/MD.0000000000015622.
- Piccolo R, et al. Drug-eluting or bare metal stents for left anterior descending or left main coronary artery revascularization. Journal of the American Heart Association. 2021; doi:10.1161/JAHA.120.018828.
- AskMayoExpert. Anti-platelet therapy for coronary stents. Mayo Clinic; 2019.
- Omar WA, et al. The current literature on bioabsorbable stents: A review. Current Atherosclerosis Reports. 2019; doi:10.1007/s11883-019-0816-4.
- Piccolo R, et al. Drug-eluting or bare-metal stents for percutaneous coronary intervention: A systematic review and individual patient data meta-analysis of randomised clinical trials. The Lancet. 2019; doi:10.1016/S0140-6736(19)30474-X.
- Mankad R (expert opinion). Mayo Clinic. May 12, 2021.
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