Drug-eluting stents: Do they increase heart attack risk?

The most common type of heart stent is generally considered safe and effective when used with anti-clotting medication.

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By Mayo Clinic Staff

A stent is a small mesh tube inserted into an artery to keep it open. A drug-eluting stent is coated with a slow-release medication to help prevent blood clots from forming in a stent.

Blood clotting in a stent can cause a future blockage (restenosis) and may lead to a heart attack.

Stents without a drug coating are called bare-metal stents.

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Drug-eluting stent safety

Today, new and improved versions of drug-eluting stents are considered safe and effective in most instances, when used with anti-clotting medication as prescribed. In general, drug-eluting stents are less likely to cause restenosis than are bare-metal stents.

A drug-eluting stent is the most common type of stent used to treat a blockage of the heart arteries. Many people with heart problems have been successfully treated with drug-eluting stents, preventing the need for more-invasive procedures, such as coronary artery bypass surgery. A heart doctor (cardiologist) places a stent during coronary angioplasty, also called percutaneous coronary intervention (PCI). In this procedure, a thin, flexible tube (catheter) with a balloon on the tip is inserted in a blood vessel. The balloon is temporarily inflated to widen the blocked artery and improve blood flow. Sometimes, a drug-coated balloon is used.

If you have chest pain due to a blocked heart artery, a drug-eluting stent can reduce your symptoms and prevent the need for repeat angioplasty procedures.

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What to consider before getting a drug-eluting stent

If you have a history of bleeding problems, a drug-eluting stent may not be a good option for you. After drug-eluting stent placement, you need to take aspirin and a stronger prescription blood thinner such as clopidogrel (Plavix) to prevent blood clotting in the stent. You may need to take a daily aspirin for the rest of your life.

Your doctor will give you additional instructions on what to expect before and after drug-eluting stent placement. Some things to consider are:

  • Do you need another type of surgery soon? If you’re considering surgery not related to your heart (noncardiac surgery) in the year after receiving your drug-eluting stent, your doctor may recommend postponing it for a year, if possible. If you can’t postpone it, a bare-metal stent may be a better option for you. Talk to you doctor about your options.
  • Do your medications need to change? Anti-clotting medications and aspirin can affect surgeries, some medical procedures and certain medications. If a noncardiac surgery can’t be postponed, talk to your doctor about all the medications you’re taking, especially aspirin or prescription blood thinners. Your dosages might need to be adjusted. It also might be possible to stop taking anti-clotting medications six months after stent placement, but this must be discussed with your doctor.

After getting a drug-eluting stent

After receiving a drug-eluting stent, your doctor will prescribe medications, such as aspirin and statins, and lifestyle changes to prevent stent or heart problems. Healthy lifestyle changes include stopping smoking, eating a more heart-healthy diet and getting plenty of exercise.

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For some people, coronary bypass surgery may be done instead of stent placement. Coronary bypass surgery works well, but it’s more invasive than using stents, which means a longer recovery time.