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Posted by on Jul 13, 2013 in Coronary artery disease | 0 comments

In a nutshell

This study investigated whether patients with aspirin intolerance could receive an alternative antiplatelet medication after coronary angioplasty with stenting.

Some background

Patients who undergo a stenting procedure to dilate the blood vessels leading to the heart (coronary arteries) need to take drugs that prevent blood clots from forming. Such drugs are termed antiplatelet drugs and include aspirin and many others. Patients who received stenting (placement of a mesh tube inside the narrowed coronary artery) typically receive a combination of two antiplatelet drugs: aspirin and clopidogrel (Plavix). Unfortunately, some people cannot tolerate or are allergic to aspirin and may not be able to benefit from stenting.

Methods & findings

This study investigated the use of alternative antiplatelet drugs in 127 patients intolerant to aspirin. These patients were treated with indobufen (Ibustrin) , trapidil (Travisco) or triflusal (Disgren) instead of aspirin following a stenting procedure. Most patients also received clopidogrel. Reasons why aspirin was not tolerated included bleeding from intestinal or stomach ulcers, allergic skin reactions and asthma attacks. Results showed that 1 year after the procedure there were no occurrences of heart attacks outside the hospital. There was a single case of stent blockage after stopping the antiplatelet therapy.

The bottom line

Results showed that the three antiplatelet drugs investigated were effective at preventing cardiovascular events and stent blockage in patients with aspirin intolerance.

The fine print

This was a rather small study that did not directly compare aspirin to the alternative antiplatelet drugs. Patients with intolerance to aspirin may benefit from stenting, but larger trials are needed to determine if using alternative drugs is indeed safe.

What’s next?

If you have intolerance to aspirin and are considering angioplasty with stenting, you should thoroughly discuss treatment options with your doctor.

Published By :

International Journal of Cardiology

Date :

Jun 05, 2013

Original Title :

Aspirin intolerance and the need for dual antiplatelet therapy after stent implantation: a proposed alternative regimen.

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