Letters Section Editor: Robert M. Golub, MD, Senior Editor.
In Reply: Dr Marret and colleagues raise questions about the reasons for premature antiplatelet therapy discontinuation and the timing between interruption and the acute coronary event. Regarding the former, in 17 patients who prematurely discontinued the dual-antiplatelet therapy, the reasons were surgery in 7 (41%), intolerance or bleeding in 6 (35%), and poor adherence in 4 (24%). Stent thrombosis occurred in 5 of the 17 patients (29%) who discontinued therapy: due to surgery in 2, due to intolerance or bleeding in 2, and due to poor adherence in 1. In 4 patients, both aspirin and clopidogrel were discontinued; in 1 patient only clopidogrel was discontinued. Patients experienced an acute thrombotic event ranging from 1 to 30 days after antiplatelet therapy discontinuation.
Iakovou I, Colombo A. Thrombosis After Implantation of Drug-Eluting Stents—Reply. JAMA. 2006;295(1):36. doi:10.1001/jama.295.1.36-b