Blood thinners are essential for many people who undergo procedures to open blocked heart arteries, particularly a treatment known as percutaneous coronary intervention (PCI).
During PCI, doctors insert a stent—a tiny tube—to keep the artery open, which helps restore blood flow.
Blood thinners reduce the risk of clots forming within the stent, preventing further blockages. However, deciding how long patients should stay on multiple blood thinners has been a complex question.
To address this, researchers recently examined guidelines from the European Society of Cardiology (ESC) to see if they could help identify which patients benefit most from extended blood-thinner use.
This study was presented at the 2023 Scientific Sessions of the Society for Cardiovascular Angiography & Interventions (SCAI).
What the ESC Guidelines Suggest
The ESC guidelines focus on patients who are at a high risk of complications after PCI. They recommend long-term use of blood thinners for individuals with certain health conditions that make them more prone to artery problems.
For example, patients who have had a heart attack in the past, have diabetes, suffer from chronic kidney disease, or have severe coronary artery disease might face higher risks of heart-related issues after PCI.
For these patients, the ESC suggests that staying on more than one blood thinner may provide added protection.
The Study’s Approach and Key Findings
The research reviewed the cases of 11,787 people who had PCI procedures between 2012 and 2019 at a large medical center. Researchers sorted these patients into low, medium, and high-risk groups based on the ESC guidelines, with each group reflecting different levels of risk for blood clots.
After a year, they analyzed how each group fared, focusing on a category of serious heart-related issues known as major adverse cardiovascular events (MACE). This category includes events like heart attacks and all-cause death. They also looked at major bleeding, a significant risk of using blood thinners.
The results showed that patients in the moderate- and high-risk groups were more likely to experience MACE than those in the low-risk group. The biggest differences involved increased rates of heart attacks and deaths in these groups.
However, the high-risk group also faced more frequent cases of major bleeding—a common side effect of prolonged blood thinner use.
Moving Toward Tailored Heart Care
The study’s lead author, Dr. George Dangas, emphasized the importance of personalized treatment in cardiology. Rather than applying a one-size-fits-all approach, he highlighted the need to assess each patient’s unique risks and benefits when deciding on long-term blood thinner use.
Dr. Dangas, who is also the President-Elect of SCAI, sees this study as a valuable step toward making cardiology treatments more individualized, with tools to help identify patients most likely to benefit from extended blood thinner therapy after PCI.
This research supports using the ESC guidelines to tailor blood thinner treatments based on specific patient characteristics, ultimately helping doctors provide the right level of care to those most at risk.
If you care about heart health, please read studies about top 10 foods for a healthy heart, and how to eat right for heart rhythm disorders.
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