What is the appropriate management of patients after cardiac stent placement?
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Therapy with clopidogrel and aspirin decreases the risk of major coronary events after percutaneous intervention (PCI), but does not reduce all-cause mortality. (SOR: A, based on a meta-analysis.) One month of combination therapy with clopidogrel and aspirin after placement of bare metal stents and up to 1 year after placement of drug-eluting stents is recommended. (SOR: C, based on practice guidelines.) Medical therapy with a combination of aspirin, angiotensin-converting enzyme (ACE) inhibitor, beta-blocker, and lipid-lowering medication is associated with lower mortality and myocardial infarction (MI) rates after PCI. (SOR: B, based on a cohort study.) Early exercise stress testing after coronary stent implantation can provide important prognostic information and help risk-stratify patients. (SOR: B, based on a cohort study.)
Evidence Based Practice 13(8): 06-07.