A Answers (2)
Cres P. Miranda, MD, Cardiology (Cardiovascular Disease), answered on behalf of MountainView Hospital
After you receive a stent - a small, metal mesh tube that is implanted to prop open your artery after a blockage has been cleared through angioplasty - you will need to take medications for a couple of key reasons: to protect your stent and to combat the cardiovascular disease that caused a blockage in the first place.
Stents can stop a heart attack in its tracks and are highly effective at relieving symptoms such as chest pain, fatigue and shortness of breath caused by other, non-life-threatening blockages. However, because a stent is a medical device, your body will at first recognize its implantation in the artery wall as an “injury” to the area and will try to heal the area. When you are healing from an injury, your blood begins to clot because of platelets - cell fragments in blood that clump together to prevent bleeding. Antiplatelet therapy is prescribed for stent patients to prevent these platelets from sticking together and forming a blood clot - a rare but potentially fatal complication that is referred to as stent thrombosis.
Current guidelines, developed by the Society for Cardiovascular Angiography and Interventions (SCAI) in conjunction with other key cardiology associations, recommend that patients who receive a bare metal stent be on aspirin (which is an antiplatelet medicine) and Plavix or Effient for at least a month after the procedure. Patients who receive drug-eluting stents are recommended to take aspirin and Plavix or Effient for at least a year after stent implantation.
The second, also important, reason to take medications after a stent has been implanted is because a stent reopens a blockage at that particular site in the artery only. The stent does not address the build-up of plaque, a fatty substance that causes cardiovascular disease, elsewhere in the arteries. A patient who has a serious blockage in one portion of an artery will have plaque build-up throughout the arteries of the body, including those leading to the brain and to the arms and legs. Medications to prevent blood clots, lower levels of LDL cholesterol (the “bad” cholesterol), manage high blood pressure, and control diabetes and other risk factors are key to improved overall cardiovascular health and reduced odds of future heart attacks, strokes and other problems. Medications to manage cardiovascular disease will be part of a treatment plan that also includes dietary changes and exercise.