Most errors in post-PCI antiplatelet therapy are not errors of choice. They are errors of handover: a patient stays on dual therapy for a year because nobody wrote down when it should end, or drops to nothing because a second prescriber assumed the first had a plan.
One line in the discharge summary fixes most of it. Name the two agents, the date dual therapy stops, and which single agent continues indefinitely. Put it where the general practitioner will actually see it, not in the procedural narrative.
Then say the same thing to the patient in plain words, and add the one sentence that prevents the worst outcome: do not stop these before any procedure without ringing the cardiology team first. Dental extractions and cataract surgery are where these drugs get stopped unnecessarily.
- State both agents, the planned stop date for the second, and the indefinite agent — all in one line.
- Tell the patient explicitly not to stop antiplatelets for dental or ophthalmic procedures without asking.
- Where the patient also needs an anticoagulant, write the triple-therapy duration in days and the date it ends.
- Confirm the plan at the first outpatient review rather than assuming the summary was read.
- Check affordability at discharge — in India a silent switch to no antiplatelet is more likely than a switch to a cheaper one.
Why it matters
The commonest antiplatelet failure is a handover gap, not a prescribing decision.
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