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Thrombosis After Implantation of Drug-Eluting Stents
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To the Editor: In their study of thrombosis after implantation of drug-eluting stents, Dr Iakovou and colleagues1 concluded that premature discontinuation of antiplatelet therapy was the strongest predictor of subacute or late thrombotic occlusion of drug-eluting stents. This is a major issue, given the increasing rate of drug-eluting stent implantation with a prolonged indication for dual-antiplatelet therapy. The study does not provide reasons 17 patients stopped using the oral antiplatelet agent. This information is important for a number of reasons.
First, interruption of antiplatelet therapy is associated with recurrent acute coronary syndromes (ACS) in otherwise stable patients. Interruption of antiplatelet therapy has been identified in 4.1% to 5.4% of all patients admitted for ACS2-3 and can lead to a catastrophic short-term outcome.2
Second, incomplete adherence and intolerance due to minor bleeding account for 20% to 30% of interruption of antiplatelet therapy.2-3 This interruption may be initiated by physicians to minimize . . . [Full Text of this Article]
Emmanuel Marret, MD
emmanuel.marret@tnn.aphp.fr
Jean-Phillipe Collet, MD, PhD;
Pierre Albaladejo, MD, PhD;
Gilles Montalescot, MD, PhD
Assistance Publique-Hopitaux de Paris
Paris, France
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