Blood thinners are important medicines that help stop blood clots from forming. These clots can be life-threatening, especially for people who have had a heart procedure called PCI, or percutaneous coronary intervention. PCI is used to open up blocked heart arteries and often includes placing a small tube called a stent to keep the artery open.
After the procedure, patients are usually given blood thinners to reduce the risk of clots forming inside the stent. But for how long should they keep taking more than one blood thinner? That has been a big question for doctors.
A recent study set out to find better answers by looking at how the European Society of Cardiology (ESC) suggests doctors manage this issue. The ESC is a group that creates medical guidelines for treating heart problems in Europe.
Their latest recommendations suggest that some people might benefit from taking more than one blood thinner for a longer period after their heart procedure—especially those who have certain high-risk conditions.
These conditions include having had a heart attack in the past, having diabetes, chronic kidney disease, or very advanced coronary artery disease. People with these health issues are more likely to have another dangerous blood clot even after their PCI is finished, so continuing with stronger blood-thinning treatment might protect them better.
To explore this further, researchers looked at data from nearly 12,000 patients who had PCI between 2012 and 2019 at a large hospital. These patients either had a sudden heart issue (acute coronary syndrome) or long-term heart disease (chronic coronary syndrome).
The researchers divided the patients into three groups: low risk, medium risk, and high risk for developing blood clots. This was based on the ESC’s list of high-risk traits.
Then, the team followed up with the patients for one year to see how many experienced serious heart problems, known as major adverse cardiovascular events (MACE). These include things like heart attacks, strokes, or death due to heart issues.
They also tracked cases of major bleeding, since taking blood thinners for a long time can increase the chance of bleeding problems.
The results showed that people in the medium and high-risk groups had a much higher chance of experiencing serious heart problems within a year compared to those in the low-risk group. These problems were mainly due to heart attacks and deaths from any cause.
At the same time, those in the high-risk group also had a greater chance of serious bleeding. This suggests that while long-term use of blood thinners may help protect high-risk patients from another heart problem, it can also increase the risk of bleeding.
Dr. George Dangas, who led the study and is the incoming president of the Society for Cardiovascular Angiography and Interventions (SCAI), said that the findings support the need for more personalized care. In other words, doctors should consider each patient’s unique risk factors when deciding whether they should stay on more than one blood thinner long after PCI.
This kind of research helps doctors make better decisions about treatment. Not every patient needs the same medicine for the same amount of time. By using tools like the ESC guidelines to figure out who’s at greater risk, doctors can offer the right level of treatment to those who need it most, without putting others at unnecessary risk of side effects.
Overall, this study shows the value of using clear guidelines and careful risk assessments to help patients stay healthier after heart procedures. If you or someone you know has had a heart stent or a PCI, it’s a good idea to talk to your doctor about the best blood thinner plan based on personal health history and current risk.
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