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Doctors advise blood thinners for heart stent patients; health advocate decries both

Tuesday, January 23, 2007 by: Ben Kage
Tags: warfarin, heart stents, blood thinners

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(NewsTarget) In an advisory issued last week, a number of doctor groups recommended that heart patients who had drug-coated stents implanted to keep blocked coronary arteries open go on a regimen of blood thinners afterward, but one health advocate says that stents are medically useless and some blood thinners have dubious origins.

The advisory came from the American Heart Association, American College of Cardiology, Society for Cardiovascular Angiography and Interventions, American College of Surgeons and the American Dental Association, and was inspired by research that showed that blood clots formed in up to 29 percent of stent patients who stopped their anti-clotting drugs soon after the surgery. Another study cited by the groups showed that the death rate for 500 patients who received a stent after a heart attack was 7.5 percent within 11 months for those who stopped taking anti-coagulants, and 0.7 percent for patients who continued to take the drugs.

In response to these results, the groups recommended that doctors put drug-coated-stent patients on anti-clotting drugs such as Plavix and aspirin, which they say will reduce the chances of reclogging in arteries because they slowly release medication. The advisory suggests patients take these drugs for a year after they have their drug-coated stent inserted.

However, a 2004 study conducted by Duke University researchers found that while stents reduce the need for repeat angioplasty surgery when placed in newly reopened coronary arteries, they have no impact in long-term mortality rates.

"Not only do stents offer no survival benefits whatsoever, but they also cause blood clots," said Mike Adams, a consumer health advocate. "Stents are, however, effective recruitment tools for entrapping patients on dangerous blood-thinning drugs made of the very same chemicals commonly used as rat poison," Adams said, referring to the popular blood-thinner Warfarin.

University of Wisconsin scientists originally developed Warfarin -- also known as Coumadin, Jantoven, Marevan, and Waran -- as a rat poison in 1948. After a man made a full recovery from a suicide attempt in which he used Warfarin in 1951, scientists began exploring the possibility of using it as an anti-coagulant. It was approved for that use in 1954.

A study published online on Oct. 11 by the American College of Cardiology found that 2,160 patients in the United States die from blood clots caused by drug-coated stents each year, prompting the FDA to form a panel of heart experts to discuss the safety of the devices. Of further concern, noted Adams, is the fact that six members of the FDA panel had financial ties to stent makers.

The risks have not gone unnoticed by patients. In an interview with the Associated Press, Dr. John Warner of the University of Texas Southwestern Medical Center said that patients were asking about the dangers of stents before doctors even bring the subject up; a positive trend, he said. He suggested that patients and doctors consider bare metal stents over drug-coated ones if the cost of the drugs or an upcoming surgery prohibited patients from using blood thinners after the stent implantation.


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