Harvard Heart Letter

Ask the doctors: Is it safe to stop taking my antiplatelet therapy?

Q. I need surgery for a gastrointestinal problem, and my question is how to handle my antiplatelet therapy, which I have been taking for two years since I had angioplasty. I take aspirin and clopidogrel, which were started after I had a heart attack and a stent was placed to keep the narrowed artery open. Things have been going just fine. But I know the surgeon wants to stop the clopidogrel during the period around surgery, and that worries me.

A. Your cardiologist will most likely ask your surgeon to let you continue taking the aspirin through the surgical period. However, you should stop clopidogrel at least a couple of weeks before surgery, if there is time, and you and your cardiologist should discuss whether it should be restarted at all afterward. The evidence that clopidogrel is helpful for more than six to 12 months after stent placement is slim. Without clopidogrel, you will be able to go through life with fewer bruises

— Thomas Lee, M.D. and Richard Lee, M.D.
Co-Editors in Chief, Harvard Heart Letter

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