This document aims to emphasize the potential complications of early discontinuation of thienopyridine therapy and to address potential strategies to minimize this occurrence.
Dual antiplatelet therapy with aspirin and a thienopyridine has been shown to reduce cardiac events after coronary stenting. However, many patients and healthcare providers prematurely discontinue dual antiplatelet therapy, which greatly increases the risk of stent thrombosis, myocardial infarction, and death. This advisory stresses the importance of 12 months of dual antiplatelet therapy after placement of a drug-eluting stent and educating the patient and healthcare providers about hazards of premature discontinuation. It also recommends postponing elective surgery for 1 year, and, if surgery cannot be deferred, considering the continuation of aspirin during the perioperative period in high risk patients with drug-eluting stents.