Discontinuing Antiplatelet Therapy Perioperatively in Patients with Drug-Eluting Stents: How Risky Is It?

The optimal management of antiplatelet therapy during the perioperative period after drug-eluting stent (DES) implantation remains controversial and challenging. Physicians must balance risk for excessive bleeding if antiplatelet agents are continued perioperatively with risk for stent thrombosis (which carries a mortality rate approaching 50%) if antiplatelet therapy is discontinued. Because studies have suggested that DESs cause recipients to be susceptible to thrombosis for a longer time than that associated with bare-metal stents, current national guidelines recommend lifelong aspirin therapy and at least 12 months of clopidogrel for patients who have undergone DES placement.

In this retrospective cohort study, researchers in Cleveland q…