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Many Don't Take Blood Thinner After Getting Stents
Date:4/20/2010

Serious risks double by waiting even a day after discharge, study finds

TUESDAY, April 20 (HealthDay News) -- One of six people who have stents implanted to keep an artery open ignore their doctor's orders to start taking the blood thinner Plavix immediately, and that ignorance nearly doubles their risk for a heart attack or death, new research finds.

The study, which involved 7,402 people who had the thin tubes put in after angioplasty, found that those most likely to benefit from the clot-preventing drug are most likely not to fill the prescription that is a standard part of the hospital discharge routine, said Dr. P. Michael Ho, an associate professor of medicine at the University of Colorado and lead author of a report published online April 20 in Circulation: Cardiovascular Quality and Outcome.

"Older patients are more likely to delay, and patients with previous heart attacks," said Ho, who is also a staff cardiologist at the Denver Veterans Affairs Health Center.

Prescriptions are almost always for clopidogrel (Plavix), the only blood thinner approved for use in the United States in 2004-2007, when the study was done. However, newer clot-preventing drugs are starting to be prescribed more often by U.S. doctors.

The study didn't look for reasons why 16.3 percent of the people who got stents implanted waited at least a day before filling their blood-thinner prescription. The median delay was three days, and 2.2 percent of those who got prescriptions never filled them.

But the study did record the hazards caused by that brief delay -- a 14.2 percent risk for heart attack or death in the next 22 months, compared with a 7.9 percent risk for those who acted promptly.

"Based on previous literature, it could be a lot of confusion about the hospital discharge process," Ho said. "They are given this laundry list of new medications, and they may not absorb all that informatio
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