Nervous about stopping Effient

Ok, it has been over a year since my heart attack and my cardiologist wants me to stop taking Effient. He says that studies show there is no real benefit for the heart after a year, but there is more risk of bleeding so he wants me to stop taking it. I have read conflicting information/stories on this. Some people have had more heart issues after stopping and some have done fine. I will still be on the daily 325mg of aspirin and all the other meds, but stopping Effient has me a bit scared. I have one stent in my LAD. Any advice from others?

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Julie,

I had to stop Effient early because I had microbial bleeding after my triple heart bypass and they said I was peeing out all the blood they were tranfusing into me and I was becoming severely anemic so I don't think you will have any issues coming off it after a year when I didn't even make it that long and was fine. It is true, it is known to cause severe bleeding issues.

I am now on Plavix after my latest stent and they wouldn't even dare try to put me back on Effient and I think the plans are for me to come off of Plavix in April as that will be 6 months and then I can have weight loss surgery and honestly after talking to my cardio this past Friday I wonder if he wouldn't have taken me off it any way whether I was having the surgery or not as after a while the risks of the drugs outway the benefits after a time and since I have proven over and over again to be a bleeder it is not worth the risk after you get to a safe zone.

Love in Christ,

Cindy

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P. S.

From your picture and the video I have to ask this...do you have a red tinge in your hair naturally??? Because that is a marker for being a bleeder according to my ICU nurses....Learn something new all the time...oh and it also makes pain control harder also...Just an FYI if you didn't know and if you have red tinge in your hair.

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Hi Julie,
I have only one stent in my LAD but I can never stop plavix, if I were told to stop I would be very nervous but I take low dose aspirin. With you being on 325 mg of aspirin it could very well do the trick. Me on the other hand have trouble taking aspirin and wish my doctor would stop that but I know he won't. Before my HA I couldn't take 81mg. How long have you been on that hight dose of aspirin?

Robin

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I have six stents and it's been almost a year since my last heart attack. I was first put on Effient and then was changed to Plavix (they never told me why it was changed). My doctor told me I'd be taking it for the rest of my life, if I stop he said that my stents would clog back up.

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I have 4 stents in my LAD and I take Effient for that. My doctor basically informed me that I would be on it for the rest of my life. I also take a low dose of Coumadin because of a previous issue with pulmonary embolii. I am on 81 mg of aspirin too. While I bleed a lot when I cut myself, I have had very little issue with it is. . .Ok, well, except for the fact I am a walking bruise. . . .

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I am really confused by this issue, I just wish they would finally come out with that study they are holding the results on. I am angry at doctors that are telling you that your stents would clog up with out the plavix. Plavix does nothing, zero, zip to prevent stents from clogging. Read it, you will see. Stent restenosis happens whether or not you take plavix. If it was true then we would just be able to put everyone in the world on plavix and there would be no clogged arteries in the first place. Plavix, effient, makes the platelets slippery and prevents blood clots, so it prevents stent thrombosis. Now if you have buildup in your stent, then having slippery platelets might prevent a clot which could cause a problem, but it does not stop the buildup. So they really are two separate issues. Plavix addresses only one. The protocol by the American cardiology institute is plavix/effient for one year after DES. Why many doctors in the US keep patients indefinitely is because they have decided that in the ABSENCE of any information saying exactly when is the best time to stop it, they will just continue it indefinitely. But, there is zero, no evidence that it has any beneficial impact past six months. Brazil continues for only three as their own studies say that is all that is necessary. In 2005 there was a study that warned of possible late stent thrombosis with DES stents. The percentage was less than one percent. So they decided that the other 99.5% would stay on plavix for an additional six months. If it saves that one person in 200, that is good. But you also must remember that the stents they were studying we're also the first generation stents, we are now in the second generation stents and they have changed them to reduce the incidence of late stent thrombosis. Plavix does also have it's risks. A 5% risk of bleeding. This can be a brain bleed. Effient has a higher bleed risk than plavix. So, your risk is .5% if you come off effient, or more than a 5% risk to stay on. Sorry for the book, I have been doing a lot of research as I come close to my year. You must decide what you feel comfortable with but I will tell you that in Canada, pretty much everyone comes off plavix at a year and increases their aspirin to 325 mg. there is never a guarantee that your stent won't clog, whether you are taking effient or not, we all have to remember that. I am sure lots of people have had a clog while on plavix/effient. I guess with heart disease, there just is no guarantee at all.

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I retread my post and it sounds preachy......sorry. I am just very frustrated with the plavix/effient issue. Duke university is doing the study and plavix did a study, they just have not released the results and it is not in their economic interest to do so. But it is frustrating, we rely on our doctors for their knowledge to guide us in making decisions. If they don't have the information, how are we not to be afraid? Either my doctor is right when he says plavix one year only, or someone else's doctor is right when they say for life, how can they both be right? If there was evidence, like a study, I would be more comfortable. I plan to go off plavix in July. That is my personal decision based on what my doctor tells me. Everyone has to make the decision based on their best information. I just am not happy about the fact that the information is so divergent depending on where you live. Surely we cannot be that different as patients?

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Thank you all for your input and information. PCHYK, I have been on 325mg of aspirin since my heart attack 12/30/10. He says I will be on that for the rest of my life. RUDOWNWITHJC, I dye my hair and am pretty sure the red tinge is from that as my natural hair color is dark brown. I am just nervous and I agree, none of us are the same and we have to decide for ourselves based on the information and recommendations of our individual physicians. I too wish they would come out with the results of the studies and come up with a protocol once and for all on Effient and / or Plavix. Again, thank you and have a great day.

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PCHYK, why did they tell you you could never stop taking Plavix?

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I've been off Effient since mid-December. I stayed on Aspirin 325mg. So far so good.

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It was a nervous time for me too when I was taken off Plavix (after 12 months) I was told pretty much the same as you Julie- cept I was told to take just baby strength aspirin.

It has been 18 months now and as far as the stents go things seem to be ok. Recently I had a problem with AFib (nothing to do with coming off Plavix) so need to take Warfarin as well the Aspirin.

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Hi Julie,
It's a kind of strange thing with where my stent is and the fact that I had very thick blood. I don't free bleed, deep cuts start to heal right away. Wounds leave no scars, the only scars I get are from burns. The placement of the stent is in a narrow spot and he says the artery it very tiny if my blood thicken back up it could close the stent. I take 81 mg aspirin or baby aspirin, my PCP tried to thin my blood before my HR but the meds made my heart skip beats and I have trouble taking aspirin so low dose is all I can take. Bottom line they want the keep my blood thin.

I think I screwed up when I stopped taking my meds for a few days, opened my thumb up with a hammer two hours ago and it didn't bleed out. Cut was nearly 1/2 inch long, it has closed already, by tomorrow you won't know it was there. Not good for me.

Robin

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Pchyk....Wow.....now I understand why they want to keep your blood thin! Take care of yourself.

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