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J Am Dent Assoc, Vol 138, No 5, 652-655.
© 2007 American Dental Association
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ASSOCIATION REPORT

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*



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

Background and Overview. Dual antiplatelet therapy with aspirin and a thienopyridine has been shown to reduce cardiac events after coronary stenting. However, many patients and health care providers prematurely discontinue dual antiplatelet therapy, which greatly increases the risk of stent thrombosis, myocardial infarction and death.

Conclusions and Clinical Implications. This advisory stresses the importance of 12 months of dual antiplatelet therapy after placement of a drug-eluting stent and educating patients and health care providers about hazards of premature discontinuation. It also recommends postponing elective surgery for one year, and if surgery cannot be deferred, considering the continuation of aspirin during the perioperative period in high-risk patients with drug-eluting stents.

Key Words: American Heart Association scientific statements; anticoagulation therapy; dental care; thrombosis; myocardial infarction; stents; myocardial stunning

Abbreviations: DES: Drug-eluting stent • MI: Myocardial infarction




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