Q. I recently had a drug-eluting stent placed in one of my coronary arteries after an episode of severe chest pain. My doctor told me I had to take Plavix every day. Now I feel perfectly fine–except for my right hip. I need a hip replacement, but my orthopedist wants to wait until I’m off Plavix before operating. How long is long enough to be on this drug?
A. A stent is a small cylindrical metal scaffold placed in a coronary artery to hold it open after a blockage has been pushed aside with a balloon. After stenting, it’s important to take an antiplatelet drug like clopidogrel (Plavix) to prevent a blood clot from developing inside the stent. Blood-thinning drugs slow down the clotting process, so you would have a lot more bleeding during your hip surgery than you would if you were not on the medication.
Just how long a person should take antiplatelet drugs after stenting is still being debated. If you stop taking them too soon, the concern is that you might develop a blood clot in the stent.
As long as you aren’t facing a medical emergency with your hip, taking Plavix for at least six months is a good idea. At six months after stenting, enough of your own cells should have coated the stent that the risk of blood clot formation is low. Waiting 12 months would be even better, if you can bear your hip pain a little longer.
— Thomas Lee, M.D. and Richard Lee, M.D.
Co-Editors in Chief, Harvard Heart Letter