Low Dose Aspirin or Plavix?

 

Aspirin or Plavix

That is the question many who have had a heart attack tend to come to at one point or another. You need to understand that aspirin and Plavix don’t work in the same way and there is a very good reason your doctor has you on both at the same time, especially if you have received coronary stents.
Aspirin works a s a natural blood thinner and by thinning the blood it reduces the chances of clotting.

Aspirin can help prevent a heart attack or a stroke in people who have never had a heart attack or stroke. Aspirin has been proved to prevent a first and second heart attack in people who have coronary artery disease. It also reduces the risk of having a stroke in those who have had a previous stroke or a transient ischemic attack (a temporary interruption of blood flow to the brain), which is often a warning sign of an impending stroke. When taken during and after a heart attack, aspirin can reduce your chances of dying.

Plavix on the other hand goes about the issue of preventing blood clots in a completely different way. Plavix tablets contain the active ingredient clopidogrel hydrogen sulphate, which is a type of medicine called an antiplatelet (sometimes referred to as a ‘blood-thinning’ medicine). It stops blood cells called platelets from clumping together and forming blood clots. Clopidogrel works by preventing a natural substance called adenosine diphosphate (ADP) from binding to its receptors on platelets. ADP is one of the chemicals in the body that cause platelets to clump together and start the process of blood clotting. As clopidogrel stops ADP from binding to platelets, it reduces the likelihood of clots forming in the blood.

Plavix is almost always prescribed along with low dose aspirin after a stent placement due to the fact of the long time it can take for the stent ( a bare metal mesh tube ) to heal over with new heart cells. A bare metal stent can take as long as 1 year to heal over and during that time the possibility of a blood clot is high if you aren’t on plavix and low dose aspirin. DES stents or drug eluting stents were brought onto the market to help that healing process and lower the risk of a blood clot in the stent area, unfortunately the medicine the stents are coated with make the healing time as much as twice as long than normal bare metal stents.

While Plavix and low dose aspirin accomplish the same goals they do so in different ways and those different ways together can make sure you have no further problem.

The question that is yet still unanswered is how long should you remain on plavix? No one knows. There have not been enough long term studies to suggest an appropriate time. So, some doctors are telling their patients to remain on Plavix indefinitely while others are suggesting 2-3 years is enough. The American Heart Association has suggested that bare metal stent recipients should stay on Plavix for at least one year while DES stent patients should stay on Plavix for a minimum of 2 years.

With the advent of disolvable stents this question may be moot in the future but for now you should listen to your doctor and continue to take both the low dose aspirin and Plavix. For those of you that find Plavix too expensive there are programs from the makers of the drug as well as pharmacies to help cut the cost or provide it for free. Either way the price pales in comparison when we are talking about your life.