Symbolic illustration of dual antiplatelet therapy protecting a stented artery.

Beyond the Pill: Are You Getting the Right Antiplatelet Therapy After a Heart Procedure?

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Lena Kashyap in Health & Wellness December 2025 • 4 min read.

"A new study reveals gaps in adherence to dual antiplatelet therapy guidelines following stent placement, highlighting the importance of informed treatment decisions."


If you've experienced a heart condition requiring a stent, you're likely familiar with antiplatelet medications. These drugs, including aspirin and clopidogrel, are vital for preventing blood clots and ensuring the success of your procedure. The combination is a cornerstone of treatment for those who've undergone percutaneous coronary intervention (PCI) after an acute coronary syndrome (ACS).

Global cardiology guidelines emphasize that this dual antiplatelet therapy (DAPT) should be prescribed to all eligible patients for up to 12 months post-stent implantation. Clinical trials have demonstrated that this regimen not only reduces the risk of blood clots but also significantly lowers the occurrence of major cardiovascular events. However, the effectiveness of this therapy hinges on patient adherence.

A recent study published in "Rational Pharmacotherapy in Cardiology" aimed to assess the real-world adequacy of DAPT among patients who had undergone PCI for acute coronary syndrome with ST-segment elevation (STEMI). The findings reveal important insights into treatment adherence and the factors influencing it.

DAPT in the Real World: What the Study Revealed

Symbolic illustration of dual antiplatelet therapy protecting a stented artery.

The study, conducted at the Samara Regional Clinical Cardiology Dispensary in Russia, tracked 311 patients who underwent bare-metal stent implantation following STEMI in 2012. Researchers followed up with these patients via telephone surveys to gather data on their medication adherence, any changes in their treatment regimen, and the occurrence of adverse events.

Here's a breakdown of the key findings:

  • Adherence Challenges: Only 54.5% of patients consistently followed the recommended DAPT for the entire year.
  • Generic Preferences: Among those adhering to DAPT, a significant proportion (62.7%) preferred generic versions of clopidogrel, primarily due to their lower cost.
  • Treatment Modifications: A substantial 25.8% of patients either switched between different brands of clopidogrel or interrupted their treatment altogether. Reasons for these changes included lack of awareness about the importance of continuous therapy, gastrointestinal issues, and bleeding episodes.
  • Monotherapy and its Consequences: A small percentage (1.7%) only took aspirin after discharge, citing the high cost of clopidogrel. Alarmingly, one patient in this group experienced a recurrent heart attack.
  • Uncertainty and Inconsistent Use: A further 18.1% of patients were taking clopidogrel but were unsure of the specific brand name, indicating potential confusion or lack of information about their medication.
These results highlight a concerning gap between recommended guidelines and real-world practice. While over half of the patients adhered to DAPT, a significant portion faced challenges in maintaining consistent therapy, raising potential risks for adverse cardiovascular events.

The Takeaway: Bridging the Gap in Cardiac Care

This study underscores the importance of patient education and support in ensuring adherence to DAPT following stent placement. Healthcare providers need to actively engage with patients, providing clear and concise information about the necessity of consistent medication use, the potential risks of non-adherence, and strategies for managing side effects. Addressing cost concerns by exploring affordable options, such as generic medications, is also crucial. Further research is needed to identify effective interventions for improving DAPT adherence and optimizing long-term outcomes for patients undergoing PCI.

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Everything You Need To Know

1

What are antiplatelet medications, and why are they important after a heart procedure?

Antiplatelet medications, like aspirin and clopidogrel, are used after procedures like stent placement to prevent blood clots. This combination of drugs is called dual antiplatelet therapy (DAPT). It is a crucial treatment, especially for patients who have undergone percutaneous coronary intervention (PCI) after an acute coronary syndrome (ACS). The effectiveness of procedures such as PCI relies heavily on the consistent use of these medications.

2

What is dual antiplatelet therapy (DAPT), and why is it recommended after a heart procedure?

DAPT, or dual antiplatelet therapy, is a combination of aspirin and clopidogrel prescribed to patients after stent implantation. The goal is to prevent blood clots and reduce the risk of major cardiovascular events. Global cardiology guidelines recommend DAPT for up to 12 months post-stent. Not adhering to DAPT can increase the risk of adverse cardiovascular events, as evidenced by the study.

3

Why is it important to take both aspirin and clopidogrel after stent placement?

After stent placement, you need to take dual antiplatelet therapy (DAPT), which includes aspirin and clopidogrel. This therapy is vital for preventing blood clots, ensuring the success of the procedure, and reducing the risk of future cardiovascular issues. Taking only aspirin, or discontinuing clopidogrel early, can significantly increase the risk of a heart attack or other adverse events, as highlighted by the findings in the study.

4

What challenges did the study identify regarding dual antiplatelet therapy (DAPT) use?

The study revealed that adherence to dual antiplatelet therapy (DAPT) guidelines is often inconsistent. Some patients switched between different brands of clopidogrel, interrupted their treatment, or chose to take only aspirin. Factors such as lack of awareness about the importance of continuous therapy, gastrointestinal issues, bleeding episodes, and cost considerations contributed to these challenges. These inconsistencies in medication use can lead to adverse cardiovascular events.

5

What should I do if I have questions or concerns about my antiplatelet medications after a heart procedure?

If you've had a stent placed, your healthcare provider will likely prescribe dual antiplatelet therapy (DAPT), which combines aspirin and clopidogrel. It's essential to discuss any concerns you have about your medications with your doctor, including side effects, cost, or any difficulties you may have in taking them. Healthcare providers should offer clear explanations and support to ensure that patients understand the importance of adhering to the DAPT plan, helping to optimize long-term outcomes after PCI.

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