Stent thrombosis: Antiplatelets alone won't do the job

doi:10.1136/bmj.39086.931019.1F

BMJ 2007;334:57 (13 January), doi:10.1136/bmj.39086.931019.1F

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Stent thrombosis

Antiplatelets alone won't do the job

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

Gershlick and Richardson say that prematurediscontinuation of clopidogrel is the greatest risk factor forthrombosis of drug eluting stents.¹ In Iakovou's series thrombosisoccurred in five of 17 patients (29%) who prematurely discontinueddual antiplatelet therapy.² One of them discontinued only clopidogrel,and the others stopped both antiplatelets (aspirin and clopidogrelor ticlopidine). We do not know whether continuation of aspirinalone would have been adequate to prevent thrombosis associatedwith drug eluting stents. Moreover, in only a minority of patients(five out of 29; 17%) did discontinuation of antiplatelets seemto have a role in the occurrence of stent thrombosis.

The tragedy of drug eluting stents is not therisk of late stent thrombosis but the fact that these deviceshave only a limited effect on patients' wellbeing. In severalrandomised trials they did not lead to a lower mortality anddid not affect the incidence of acute . . . [Full text of this article]

Hans Van Brabandt, cardiologist

¹ B2800 Mechelen, Belgium van.brabandt@pandora.be

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Drug eluting stents: A H Gershlick and G Richardson
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