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Plavix
I am taking plavix for 10 years for a long history with heart problems.  Stent,heart attack etc..  I am wondering how long a person should be on this.
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367994 tn?1304957193
Lately, there have many posts related to the duration of plavix and it seems patients are given plavix for a long period of time.  It has been my understanding from what I have read and my experience, plavix is recommended for individuals that have a drug eluding stent to help prevent clots for up to a year. That has been my experience.

DES when compared to bare metal stent implants have an increase of clots and restenosis for a period of one year...after that time the risk is very low and plavix is no longer of any benefit and the patient is on aspirin indefinitely as with the BMS.

Plavix may be recommended for patients that have a high risk for clots, and that risk exceeds the probability of excessive bleeding that can occur with plavix. Some heart conditions have a higher risk for clots such as arrythmia, etc. The doctor may want to treat for a long period of time.

Hope this helps, and if you have any further questions or comments you are welcome to respond.  Take care,

Ken
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367994 tn?1304957193
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976897 tn?1379171202
The general consensus on Plavix is fast changing. It was once thought that there was no evidence in benefits after one year, but evidence is now proving the opposite. Once the medication is stopped, many patients start to develop blockages in the stents. The trend is fast tracking towards "for life". I was initially told 1 year to 18 months, now I've been told plavix is for life.
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976897 tn?1379171202
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63984 tn?1385441539
This discussion topic is a slippery slope of thoughts, studies, and opinions.  

I have both bare-metal and drug eluding stents in place, four of each, and took Plavix for twelve years.  I was asked to take the drug not only to keep clots from forming in my stents, but also to maximize blood flow in what are called collateral arteries, little ones that develop to help supply damaged areas of the heart.  I recently had bypass surgery that was extremely successful, and have been taken off Plavix as I have no angina symptoms at all.  Plavix is prescribed for a variety of reasons.  Best wishes, keep us informed.
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63984 tn?1385441539
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367994 tn?1304957193
Personally, I would not take Plavix for the long term as the risk in my view excessive internal bleeding from a stroke and/or the digestive system. For me, aspirin for the long term is sufficient although Plavix has a different mechanism to prevent clots.

However, some in the medical community may be relying on CPARIE trial!!.
"Evidence is available from retrospective analysis of the CPARIE trial with clopidogrel that patients who have atherosclerosis in other vascular beds, such as prior ischemic stroke or concurrent peripheral vascular disease, benefit from receiving clopidogrel over aspirin. Some cardiologists have concluded that these patients, who are at higher risk of a subsequent vascular event, would benefit from combined therapy. In addition, subgroup analysis from CAPRIE has documented that patients who have undergone coronary artery bypass surgery receive particular benefit from continuing combined antiplatelet therapy with clopidogrel and aspirin.

Thus the durations of clopidogrel therapy combined with aspirin that may be used range from one month to 3 months to 9 months to one year to life-long therapy!

Ken
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