Drug-Eluting Stents: Patient Understanding of the Risks of Premature Cessation of Antiplatelet Drugs

Objective: Drug-eluting coronary stent use is common. Antiplatelet drug use after stent placement is necessary to prevent stent thrombosis. It has been recommended that at the time of stent placement, patients be given instructions regarding stopping antiplatelet drugs before elective surgery. Unfortunately, patients may be given inappropriate preoperative instructions by health care providers or may stop the drugs on their own. This can lead to perioperative myocardial infarctions and death. Design: Survey. Setting: Preoperative evaluation clinic of 2 teaching hospitals. Participants: One hundred sixteen patients with coronary stents completed a 13-question survey. The questionnaire assessed patient understanding of stent type and the risks of stopping antiplatelet drugs, in addition to communication among the patient, their surgeon, and their treating cardiologist before elective surgery. Intervention: None. Measurements and Main Results: The majority of patients stated either they had received no instructions from their implanting cardiologist regarding future surgery and antiplatelet drugs or they were unsure if any instructions had been given. Most patients (57%) received antiplatelet instructions regarding their planned surgery from their surgeon, whereas only 14% received instructions with (known) cardiology input. The majority of patients were unaware or unsure of any risk in prematurely stopping their antiplatelet drugs. Conclusion: Many patients are unaware of their stent type and the risks of inappropriately stopping antiplatelet drugs. Furthermore, they may have received either inappropriate preoperative instructions or no instructions at all. The opportunity exists to improve preoperative communication with patients in order to minimize perioperative thrombotic risks of coronary stents.