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

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

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

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

Drug-eluting stent safety

Today, new and better versions of drug-eluting stents are available. These stents are safe and effective for most people when used with anti-clotting medicines as prescribed. In general, drug-eluting stents are less likely to cause blockages 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. Use of these stents may prevent the need for more-invasive procedures, such as coronary artery bypass surgery.

A heart doctor, called a cardiologist, places a stent during coronary angioplasty, also called percutaneous coronary intervention. In this procedure, a thin, flexible tube, called a catheter, with a balloon on the tip is put in a blood vessel. The balloon is inflated for a short time to widen the blocked artery and help blood flow. Sometimes, a drug-coated balloon is used.

For chest pain due to a blocked heart artery, a drug-eluting stent can lower the symptoms. It also may prevent the need for more angioplasty procedures.

What to consider before getting a drug-eluting stent

A drug-eluting stent may not be a choice for people with a history of bleeding problems. That's because aspirin and a prescription blood thinner such as clopidogrel (Plavix) must be taken. This is to help stop blood from clotting in the stent. Having a drug-eluting stent might mean taking a daily aspirin for life.

A healthcare professional can give more instructions on what to expect before and after drug-eluting stent placement. Some things to consider are:

• Needing another type of surgery soon. A healthcare professional might recommend waiting to have noncardiac surgery for one year after getting a drug-eluding stent. Noncardiac surgery is any surgery not related to the heart. For those who can't wait to have surgery, a bare-metal stent may be a better choice.
• Needing a change of medications. Blood thinners and aspirin can have an effect on surgeries, some medical procedures and some medicines. If a noncardiac surgery can't be postponed, a healthcare professional might change the dose of anti-clotting medicines and aspirin. It also might be possible to stop taking anti-clotting medicines six months after stent placement, but only with the approval of a care team.

After getting a drug-eluting stent

After you get a drug-eluting stent, a healthcare professional prescribes medicines, such as aspirin and statins, and lifestyle changes. These are ways to help keep problems from happening with the stent or your heart. To change your lifestyle in a healthy way, stop smoking, eat a heart-healthy diet and get plenty of exercise.

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.