Drug-eluting stents: Do they increase heart attack risk?
The most common type of heart stent is generally considered safe and effective when used with anti-clotting medication.By Mayo Clinic Staff
A stent is a small mesh tube inserted into an artery to keep it open. A drug-eluting stent is coated with a slow-release medication to help prevent blood clots from forming in a stent.
Blood clotting in a stent can cause a future blockage (restenosis) and may lead to a heart attack.
Stents without a drug coating are called bare-metal stents.
Drug-eluting stent safety
Today, new and improved versions of drug-eluting stents are considered safe and effective in most instances, when used with anti-clotting medication as prescribed. In general, drug-eluting stents are less likely to cause restenosis than are bare-metal stents.
A drug-eluting stent is the most common type of stent used to treat a blockage of the heart arteries. Many people with heart problems have been successfully treated with drug-eluting stents, preventing the need for more-invasive procedures, such as coronary artery bypass surgery. A heart doctor (cardiologist) places a stent during coronary angioplasty, also called percutaneous coronary intervention (PCI). In this procedure, a thin, flexible tube (catheter) with a balloon on the tip is inserted in a blood vessel. The balloon is temporarily inflated to widen the blocked artery and improve blood flow. Sometimes, a drug-coated balloon is used.
If you have chest pain due to a blocked heart artery, a drug-eluting stent can reduce your symptoms and prevent the need for repeat angioplasty procedures.
What to consider before getting a drug-eluting stent
If you have a history of bleeding problems, a drug-eluting stent may not be a good option for you. After drug-eluting stent placement, you need to take aspirin and a stronger prescription blood thinner such as clopidogrel (Plavix) to prevent blood clotting in the stent. You may need to take a daily aspirin for the rest of your life.
Your doctor will give you additional instructions on what to expect before and after drug-eluting stent placement. Some things to consider are:
- Do you need another type of surgery soon? If you're considering surgery not related to your heart (noncardiac surgery) in the year after receiving your drug-eluting stent, your doctor may recommend postponing it for a year, if possible. If you can't postpone it, a bare-metal stent may be a better option for you. Talk to you doctor about your options.
- Do your medications need to change? Anti-clotting medications and aspirin can affect surgeries, some medical procedures and certain medications. If a noncardiac surgery can't be postponed, talk to your doctor about all the medications you're taking, especially aspirin or prescription blood thinners. Your dosages might need to be adjusted. It also might be possible to stop taking anti-clotting medications six months after stent placement, but this must be discussed with your doctor.
After getting a drug-eluting stent
After receiving a drug-eluting stent, your doctor will prescribe medications, such as aspirin and statins, and lifestyle changes to prevent stent or heart problems. Healthy lifestyle changes include stopping smoking, eating a more heart-healthy diet and getting plenty of exercise.
For some people, coronary bypass surgery may be done instead of stent placement. Coronary bypass surgery works well, but it's more invasive than using stents, which means a longer recovery time.
June 11, 2021
From Mayo Clinic to your inbox
Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health.
ErrorEmail field is required
ErrorInclude a valid email address
To provide you with the most relevant and helpful information, and understand which
information is beneficial, we may combine your email and website usage information with
other information we have about you. If you are a Mayo Clinic patient, this could
include protected health information. If we combine this information with your protected
health information, we will treat all of that information as protected health
information and will only use or disclose that information as set forth in our notice of
privacy practices. You may opt-out of email communications at any time by clicking on
the unsubscribe link in the e-mail.
Thank you for subscribing
Our Housecall e-newsletter will keep you up-to-date on the latest health information.
Sorry something went wrong with your subscription
Please, try again in a couple of minutes
See more In-depth
- Stents. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health-topics/stents. Accessed April 14, 2021.
- Cutlip D, et al. Drug eluting intracoronary stents: Stent types. https://www.uptodate.com/contents/search. Accessed April 14, 2021.
- Bonow RO, et al., eds. Percutaneous coronary intervention. In: Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Elsevier; 2019. https://www.clinicalkey.com. Accessed April 14, 2021.
- Cho S, et al. Long-term efficacy of extended dual antiplatelet therapy after left main coronary artery bifurcation stenting. The American Journal of Cardiology. 2020; doi:10.1016/j.amjcard.2019.10.046.
- Coronary heart disease. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health-topics/coronary-heart-disease. Accessed April 14, 2021.
- Min L, et al. Drug-coated balloon versus drug-eluting stent in de novo small coronary vessel disease: A systematic review and meta-analysis. Medicine. 2019; doi:10.1097/MD.0000000000015622.
- Khang SH, et al. Stent thrombosis with drug-eluting stents and bioresorbable scaffolds: Evidence from a network meta-analysis of 147 trials. JACC Cardiovascular Interventions. 2016; doi:10.1016/j.jcin.2016.03.038.
- AskMayoExpert. Anti-platelet therapy for coronary stents. Mayo Clinic; 2019.
- Omar WA, et al. The current literature on bioabsorbable stents: A review. Current Atherosclerosis Reports. 2019; doi:10.1007/s11883-019-0816-4.
- Piccolo R, et al. Drug-eluting or bare-metal stents for percutaneous coronary intervention: A systematic review and individual patient data meta-analysis of randomised clinical trials. The Lancet. 2019; doi:10.1016/S0140-6736(19)30474-X.
- Mankad R (expert opinion). Mayo Clinic. May 12, 2021.