BMJ  2006;333:1233-1234 (16 December), doi:10.1136/bmj.39058.554884.BE

Editorials

Drug eluting stents

Dual antiplatelet therapy should not be discontinued without referral to a cardiologist

The first 150 words of the full text of this article appear below.

Last week an expert panel of the US Food and Drug Administration (FDA) recommended that the FDA should issue warnings to doctors and patients about drug eluting coronary stents. The safety of such stents is unclear except in low risk patients. Furthermore, patients with drug eluting stents should take antiplatelet therapy for at least one year after insertion.

Percutaneous coronary intervention is the dominant treatment for patients with coronary artery disease; 73 000 procedures were performed in the United Kingdom in 2005, compared with 25 000 coronary artery bypass operations. Drug eluting stents have been part of the procedure since 2002 as they reduce the risk of in-stent restenosis.

In-stent restenosis, caused by injury induced cell proliferation and scar tissue formation, requires repeat intervention in 12-20% of patients receiving a bare metal (non-drug eluting) stent.1 Randomised trials have shown that drug eluting stents, which are coated with agents such as . . . [Full text of this article]

A H Gershlick, consultant cardiologist (, G Richardson, consultant cardiologist

1 University Hospitals of Leicester, LE3 9QP

agershlick@aol.com


Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to StumbleUpon StumbleUpon   Add to Technorati Technorati    What's this?

Relevant Articles

Stent thrombosis: Antiplatelets alone won't do the job
Hans Van Brabandt
BMJ 2007 334: 57. [Extract] [Full Text] [PDF]

Stent thrombosis: Patient card on discontinuing clopidogrel is available
Sotiris Antoniou and Martin T Rothman
BMJ 2007 334: 57. [Extract] [Full Text] [PDF]

Stent thrombosis: Consider also low response to antiplatelets
Andrew J Wiper and David H Roberts
BMJ 2007 334: 57. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

  • Veitch, A M, Baglin, T P, Gershlick, A H, Harnden, S M, Tighe, R, Cairns, S (2008). Guidelines for the management of anticoagulant and antiplatelet therapy in patients undergoing endoscopic procedures. Gut 57: 1322-1329 [Full text]  
  • Henriksen, P. A., Palmer, K., Boon, N. A. (2008). Management of upper gastrointestinal haemorrhage complicating dual anti-platelet therapy. QJM 101: 261-267 [Abstract] [Full text]  
  • Howard-Alpe, G. M., de Bono, J., Hudsmith, L., Orr, W. P., Foex, P., Sear, J. W. (2007). Coronary artery stents and non-cardiac surgery. Br J Anaesth 98: 560-574 [Abstract] [Full text]  
  • Van Brabandt, H. (2007). Stent thrombosis: Antiplatelets alone won't do the job. BMJ 334: 57-57 [Full text]  
  • Antoniou, S., Rothman, M. T (2007). Stent thrombosis: Patient card on discontinuing clopidogrel is available. BMJ 334: 57-57 [Full text]  
  • Wiper, A. J, Roberts, D. H (2007). Stent thrombosis: Consider also low response to antiplatelets. BMJ 334: 57-57 [Full text]  

Rapid Responses:

Read all Rapid Responses

A little more about Drug Eluting Stents
Russell W J Millner
bmj.com, 19 Dec 2006 [Full text]
Heparin and glycoprotein IIb/IIIa antagonist-induced thrombocytopaenia increase bleeding and death in cardiac patients – platelets may not help
Amit Patel
bmj.com, 21 Dec 2006 [Full text]
Drug eluting stents: A wake up call?
Kiran CR Patel
bmj.com, 21 Dec 2006 [Full text]
Coronary stent thrombosis and oral antiplatelet “low responders” – should we be looking harder and treating harder?
Andrew J Wiper, et al.
bmj.com, 26 Dec 2006 [Full text]
Risks of bleeding
A G hameed
bmj.com, 26 Dec 2006 [Full text]
Premature discontinuation of clopidogrel - the need for patient empowerment
Sotiris Antoniou, et al.
bmj.com, 1 Jan 2007 [Full text]
Antiplatelets alone won't do the job.
Hans Van Brabandt
bmj.com, 4 Jan 2007 [Full text]
We already have a problem
Phil S Jones
bmj.com, 8 Jan 2007 [Full text]
Stent Thrombosis: Fine Tuning Opinion
Anthony H Gershlick, et al.
bmj.com, 2 Feb 2007 [Full text]



Access jobs at BMJ Careers
Whats new online at Student 

BMJ