Patients on dual antiplatelet therapy after a recent stent are often told by another clinician or a dentist to stop their medicines before a procedure. Premature interruption of dual therapy soon after stenting is a recognised cause of stent thrombosis.
Most dental work and many minor procedures can proceed on antiplatelet therapy with local haemostatic measures. Where interruption is genuinely needed, the decision should involve the treating cardiologist and take account of how recently the stent was placed.
- Tell patients with a recent stent not to stop an antiplatelet without speaking to their cardiology team.
- Give them a written card stating the stent date and their antiplatelet plan.
- When another team asks to stop therapy, weigh the procedure's bleeding risk against the time since stenting.
- Most dental extractions can proceed on aspirin with local measures.
Why it matters
The person who stops the drug is rarely the person who sees the stent thrombosis.
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