Clopidogrel and side effects

[sanatogen]

I would be interested to hear from the people who are on Clopidogrel after procedure of stenting done.   My husband is 69
and recently had stents put in.  To make this work as a routine he now has to continue with the blood thinner CLOPIDOGREL along with his usual Aspirin daily.  Also a daily walking for one hour.  I am so grateful to the Doctor who made it possible for my husband to get relief from his Angina.  My question to the people who are on the same boat.....
Do you get an awful bruising easily?   Some bruising is common I heard but my worries are regarding cerebral haemorrhage.   If a person bleeds so easily with these blood thinner meds,  are they safe from having any sinister internal bleeding?   My husband has always been hypertensive PRIOR to this procedure ( from his age of 35+) BUT surprisingly that has been so much better after this procedure which is a reassurance for my fear.  He also had a
history of GI bleeding 15yrs ago from a bleeding duodenal ulcer but he was only on aspirin then.   That was successfully treated and has never happened again.

Please share your experience with Clopidogrel, any side effects, your own experiences and your Doctor's opinion.
THANK YOU.

[sanatogen]

Sorry to hear about your GI bleeding from Clopidogrel.   There is an alternative
medication but I just don't know the details.   Your cardiologist should be able to
guide you hopefully.   My husband had a history of GI bleeding some 12 years
ago which was sucessfully treated.  His current treatment with Clopidogrel,
makes us worried but without this medication stenting won't be successful.

I hope and very much wish that someone with knowledge of alternate med can
enlighten us.

Please keep your BP under control since this is extremely important in cardiovascular illnesses.

[kenkeith]

I have answered your posted question on the subject.  It seems you have a greater risk for bleeding than than the probability of a blood clot following your DES implant.

[caroljk]

I had  a stent placed because of CT findings, no chest pain ever, but I do have hypertention
that is hard to control. Problem is Plavix it has caused GI bleeding and hospitalization 5 events I am always told to go back on Plavix because it is necessary but I have started to bleed again feel awful, tired all the time and sick of transfussions. Has anyone else had this problem? Is there any other medication for a medicated stent? or any way to check progress of plaque build up?

[ChatterAlly]

Your problem sounds like mine.  It was only recently diagnosed as coronary artery spasms.  I think the stent is causing them.  Take care.

[sanatogen]

You seem to be taking medications with devotion, just the way my husband is doing.  I am a
bit surprised with the recurrence of your angina.   Please don't leave it for too long, just see the doctor and find out the reason.  Please keep us informed.
I very much wish a good recovery to all of us on this forum.
Sanatogen

[sanatogen]

Get well soon, is my sincere wish to both of you.   I would also like to hear regarding your
husband's and your speedy recovery.
Take care,
Sanatogen

[ed34]

This must be a huge range, from zero minutes to several months, depending how stunned the cells are and how many. When I had my first stent in my coronary arteries it was to stop episodes of MI. I had been suffering severe angina for two years which had been diagnosed as a stomach disorder. As soon as the stent was inserted I could eat with no pains and there was no sign of angina at all, it was instant.

[oldie]

Any way of estimating how long it takes heart muscles weakened by blocked artery to recover after a stent is placed. Six weeks ago my RCA, 95%  blocked , was stented. I never had any angina pain, only occasional discomfort in the heart area with lightheadedness and the need to breathe harder. This occurred at rest, never with hard exercise. I now have the same events a little more frequently. I thought the increased blood flow via the stent would stop them. Does it take time? Should I wait for the muscles cells to perk up - a few months, weeks? I can't believe the intervention was faulty although the CD of it shows puffs of what look like contrast dye escaping from a leak in the artery at the point where the stent was placed. The cardio says the procedure was normal

[ChatterAlly]

I would very much like to read a post from you after this!  Take care, Ally

[ed34]

Unfortunately since the left artery was reopened with 5 long stents, my angina symptoms have progressively worsened over the months to the point where I often feel as bad as I did before the procedure. I have an appointment next month with a Cardiologist to whom I will be requesting we do a CT scan to ensure the stents are still open.

[ChatterAlly]

Walking is a tremendous help to me.  I have had many problems with my blood pressure.  It was first diagnosed when I was 41. I started walking to lose some weight about 7 years ago.  With diet and exercise I was able to drop 40 lbs in 5  months.  But, I still ended up in the ER after the first year of walking and required a stent.  It was then that I started on blood pressure meds and the aspirin and Plavix, etc.  It was by choice that I stopped taking the Plavix.  I know the doctors would prefer that I continue with this, but I don't care for the side effects.  I felt great until last summer when I wasn't able to walk.  There was a heat wave in this part of Texas and I couldn't tolerate the intense heat. I tried, butended up a sweating mess.  Now a year later I do not have the energy I had and I have dealt with heart spasms so much.  I am convinced I need to just start walking again.  If I continue to have the heart spasms after resuming the walking then I will have to be re-evaluated again.  Change in meds or even bypass surgery will be needed.  It's great that you encourage and support your husband the way you do.  My husband is going through chemo therapy now and that is a challenge for us both.  He watches over me.  Doesn't want me working in the yard alone.  And I am the same way with him.  Take care, Ally

[sanatogen]

Thanks for your kind reply.   My husband has hypertension from an early age too but was not diagnosed or treated.   At the age of 30yrs when BP was first checked his diastolic pressure was over 90 ( can not exactly remember the systolic).  Thereafter, he was always told that he had labile hypertension and no treatment was given.  Unfortunately, even just 15/20 years ago, generally, hypertension was NOT taken seriously in the UK  and yet high BP is a major risk factor causing heart attack and cerebro vascular accident.   Same with high cholesterol.

Yes, you are very right that we should feel rather safe with Clopidogrel.   We do NOT want to go back to sq. one after taking all these trouble of going through cardiac invasive procedures.

   Are you doing your daily walking? This certainly is helping my husband ( along with Clopidogrel ofcourse!) except that MY poor old knee is bothering a wee bit but this won't
stop me since I know that he may not get the encouragement unless we walk together.

My best wishes to you with your treatment and health.  If you come across any new info regarding this topic or similar, please let us know.  

A BIG THANK YOU.

[ed34]

Before my first stent, from my teen years, I had quite high blood pressure, averaging 140/85-90 but Doctors always simply said "oh youre just someone with high pressure " and did nothing about it. After my first stent, I was put onto 5mg ramapril daily which kept my blood pressure around 120/70. My angina worsened a few months later but it was known why, my left artery was totally blocked. So in sept 07 I had a triple bypass. After the surgery my blood pressure went to 120/70 with no medication at all. Sadly, after 3 months, the veins used in the bypass surgery failed and I was told to consider a transplant. I spent 2 years speaking with different cardiologists and eventually found one in London who said he could stent my left artery. All other cardiologists warned me it was far too risky, but to me a transplant carried more risk. So in sept 09 I had 5 long stents put down my left artery. My blood pressure seemed to raise to 145/102 on average, so I am now back on Ramapril. It is important to keep blood pressure to the lower range of normal, to reduce the risks of artery damage. However, it would take a seriously weak vessel for a hem to occur with normal pressure, such as a weak aneurysm. If I have any of those in my brain I have no idea, and to be honest I have no idea what difference it would make not being on plavix. My Mother had a burst aneurysm in her brain and was on no blood thinners. The vessel didn't clot on its own and surgery was required to seal it. In those days they didn't use stents or coils in the brains vessels, this was a skull open and metal clip job. So looking at her situation, not being on plavix, I can't see what difference it makes.
The way I look at the situation is this.  With plavix you are less likely to form a clot in the brain causing stroke. There is 'supposedly' a tiny risk with plavix that a aneurysm will burst and not seal, but many do not anyway. So my opinion is you are safer on plavix.  My Cardiologist explained to me that there have been some cases where plavix has been stopped after a year and clots have very quickly formed in the stents. This is why the UK is now suggesting a minimum of 2-3 years and are considering saying for life. A clot can form very quickly anywhere in the body, including stents. You have seen how quickly a cut clots, imagine this in an artery, it takes just minutes. So I feel safe going with the advice of my Cardiologist in the case of plavix. You are correct in your opinion of blood pressure having to stay in the normal range to reduce risks.
I hope this helps you.

[sanatogen]

It's really helpful to know regarding your experience/opinion  with Plavix and Aspirin.   My
husband's concern and fear is "cerebral hge" but as we can see there is no easy solution.  At least the stenting procedure is an option these days unlike 14 yrs ago they could only do bypass or conservative medical therapy or just a balloon angioplasy without any stent.  There would always be some side effects from any medication but as you said Warfarin is also a powerful anticoagulant and we know so many people have to be on it.  

So, you have been on Plavix from Feb 07?  More than 3yrs on Plavix?   Your  post really
is  reassuring and helpful.  

My husband's  BP went down temporarily after being on anti anginal med isosrbide mononitrate which you would know is a vasodilator.   He was also having postural hypotension  soon after his stenting procedure for about 2/3 days.   It went down a bit too low, so his usual anti hypertensive med along with isosorbide all needed to be discontinued
temporarily.   Now that he does not have angina ( 12 min on treadmill ok), he does not
need isosorbide  BUT  his Blood pressure slowly creeping upwards.   Nothing alarming but
just that he should restart them and he did it.     I feel a weak vessel along with high BP can be a risk factor.   My husband's BP has always been labile and can shoot up all on a sudden.   For that reason his cardiologist although happy with his post stent progress,
advised him to continue with his anti hypertensive measures.  

Did you ever have blood pressure problem?   It would help to know your views.

Wish you all the best.
  

[ed34]

My first stent was inserted in Feb 07, and I was on plavix for 18 months. An angiogram performed in Sept 09 showed the stent still fully open with no signs of any disease.
I do bruise more easily with Plavix, if you don't then there's something wrong. The whole idea of Plavix and Aspirin is to stop you clotting so quick. If I cut myself shaving it takes what seems like an eternity to stop bleeding. I had 5 further stents in Sept 07 and this was to open a blockage in my left artery, one which a failed triple bypass couldn't resolve. I have been told this time I will be on plavix for a minimum of three years or maybe even indefinitely. The reasons I was given are that some people who come off plavix after 12 months have developed severe clotting in the stents. I have to say I feel much safer on plavix, knowing my stents aren't forming clots. It's also nice to know you are at a lower risk of strokes. With regards to the risk of internal bleeding, my Cardiologist said this is very rare and you would really need weak vessels for this to occur. He said the real risk is with more powerful anticoagulants such as Warfarin and its family.

[sanatogen]

His doctor is aware of the medical history as it's a must for him to know.  The bleeding ulcer
was cauterised and treated with triple therapy ( antibiotic+metronidazole+omiprazole) 15yrs
ago since it was due to halicobactorpylori.  He does NOT drink,neither smokes.   His high
cholesterol (normal with statin),  Hypertension ( controlled with med) and duodenal ulcer
( never relapsed after treatment) are all familial unfortunately.  For that reason, his lifestyle has always been particularly healthy.  His first angiogram was 14yrs ago when a lot of narrowing
of the vessels were found but they only left him on statin and aspirin along with anti hypertensive ( Not the same doctor and not the same hospital).   Ever since, he lives on fruits, veg and grilled/steamed fish.  Yet, his angina gradually got worse in recent days but most likely it took 14yrs because of his healthy lifestyle.

Regarding my concern of a cerebral bleeding as I mentioned earlier, some medicos think
that if the blood pressure is on the higher side, then only you may worry with Clopidogrel.
Do any of you suffer from Hypertension while you are also on Clopidogrel?  

My husband is on anti hypertensive ( Telmesartan ie Micardis) and that keeps his BP under control.   Another most important thing I am delighted to mention that my  husband  had to stop after walking 25 yards due to angina (just prior to stenting), now walking with me for full one hour, a brisk walk without a single stop.  He had six stents put in ( single procedure) just two months ago.  We are taking this walking advice as the most important medication.   If he can successfully continue this clopidogrel and aspirin along with this
daily walk, then I would be just grateful to God.

A BIG THANK YOU TO YOU ALL who shared their experiences and opinion.  It helps to
know that there are others with similar situation and similar experience.  Please share
your other post stenting experiences.

Thank you.

[Flycaster305]

This is a very interesting and important question you raise.  

I'm not aware of high risk of stroke in the population of people taking Plavix.  My guess it is less as it it inhibits blood clots, but if a stroke would occur, it would complicate the issue.  Like your husband, I bruise extemely easily and I am taking both Plavix as well as 80mg aspirin.  I've had eight stents, the last one in 2007, and was off the drug for a couple of years until I developed small vessel disease in vessels too small to stent, it was thought that the Plavix might ease the angina symptoms.  That being said, I expect that I will be told I don't need to take it anymore next Monday at my appointment, that was suggested at my last visit.

Plavix has a great history of preventing restinosis, and I would certainly follow your doctor's orders regarding the drug.  The bigger concern with Plavix with me is those 'emergency' moments.  I had a double bowel obstruction requiring emergency surgery immediately several years ago when taking plavix, and bleeding was a concern and a problem during the surgery.  That being said, I'm still standing.

[kenkeith]

I had a regimen of aspirin and plavix 6 years ago to help prevent restenosis (blood clot) at the site of a drug enduced stent (DES).  There is a small percentage of people that may benefit from the dual regimen, and one year post stent implant procedure the benefit/ risk now favors the risk outweighs the benefit.  

I did not have any easy bruising,  and if there is easy briusing that indicates a higher risk for excessive bleeding and the risk may outweigh the benefit. With your husbands health history, certainly adds to the risk. Plavix helps prevent about one percent risk of restenosis with DES.

[ChatterAlly]

Is his doctor aware of the history of a bleeding ulcer that your post mentions? Has the ulcer completely healed? I certainly would make sure the doctor is aware of this. I know in my case, when taking the Plavix I couldn't drink.  I love to drink wine and while on the Plavix one glass would go straight to my head.  I felt drunk.  And, yes,the bruising is terrible.  I walk around with purple marks on my arms all the time.  All I have to do is brush against something and I either start bleeding or I am left with a bruise.  Take care, Ally