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Drug-eluting stents: Do they increase heartattack risk?
Drug-eluting stents, once thought to increase heart attack risk, aregenerally considered safe if used properly.
Stents are used to keep arteries open after a procedure called angioplasty. Some researchershad worried that a popular type of stent that slowly releases medication over time (drug-eluting stents) may actually increase a person's risk of having a heart attack.However, since these concerns surfaced, a number of studies have shown that drug-elutingstents are safe and a good option for many people. Find out the differences between drug-eluting stents and bare-metal stents, what you should ask your doctor before having a stent placed, and what you should do after you get a drug-eluting stent.
What's a stent? 
Stents are metal mesh tubes inserted during angioplasty. Angioplasty is a catheter procedurethat involves temporarily inserting and blowing up a tiny balloon where your artery is cloggedto help widen the artery. Stents help prevent restenosis — when the artery becomes blockedagain. Without the use of stents, about 30 percent of arteries become blocked again.There are two basic kinds of stents: bare-metal stents and drug-eluting stents.
Bare-metal stents
are metal stents with no special coating. Bare-metal stents act assimple scaffolding to prop open blood vessels after they're widened with angioplasty.As the artery heals, tissue grows around the stent holding it in place. However,sometimes an overgrowth of this scar tissue in the arterial lining increases the risk thatthe artery will become blocked again.
Drug-eluting stents
are coated with medication that is slowly released (eluted) to help prevent the growth of scar tissue in the artery lining. This helps the artery remainsmooth and open, assuring good blood flow through it. Drug-eluting stents weredeveloped because in some of those who get bare-metal stents, tissue growth over thestent eventually leads to re-blockage.Many people with heart problems have been successfully treated with drug-eluting stents, preventing the need for more-invasive procedures, such as coronary artery bypass surgery.The reduced risk of re-narrowed arteries from drug-eluting stents reduces the need for repeathospitalization and angioplasty procedures — each of which carry some risk of complicationsincluding heart attack and stroke.
What are your options for treating clogged heart arteries? 
Drug-eluting stents are just one option for treating narrowed heart arteries. It's worthremembering that you basically have four options if your arteries become narrowed, each withrisks:
 
Drug-eluting stents.
Drug-eluting stents are safe and effective in most circumstances.The key to making this treatment option effective is that you must be willing to takeyour medications as they're prescribed. Medications can make it less likely that bloodclots in your heart will dislodge and cause a heart attack. These stents work well andhave a lower rate of restenosis than do bare-metal stents.
Bare-metal stents.
These stents can work well, but have a higher rate of restenosisthan do drug-eluting stents. If you'll need some type of surgery that's not related toyour heart (for example, a stomach or hernia operation), soon after your stent placement, you may do better with a bare-metal stent.
Coronary bypass surgery.
Bypass surgery is used to divert blood around blockedarteries in the heart. This surgery uses a healthy blood vessel taken from your leg, arm,or chest and connects it to the other arteries in your heart so that blood is bypassedaround the diseased or blocked area. While bypass surgery works well, it's also moreinvasive than using stents, which means a longer recovery time. In addition, the risk of complications for bypass surgery can be higher than with stents.
Medications and lifestyle changes.
This is a good option for many people. If youhave symptoms from your narrowed coronary arteries, such as angina, and your condition isn't severe or immediately life-threatening, it may be worth first tryingmedications, such as statins, and lifestyle changes, such as eating a more balanceddiet. This option can be as effective as receiving a stent, especially for those who don'thave chest pain (angina). Keep in mind that even if you receive a stent, your doctor will likely also prescribe medications, such as statins, and lifestyle changes.
What should you do if you have a drug-eluting stent? 
It's very important that you take anti-clotting medications exactly as directed by your doctor.Here's what to do if you have a stent of any kind:
Take aspirin.
If you have a stent, you'll have to take aspirin daily and indefinitely toreduce the risk of clotting. Follow your doctor's instructions on how much and whattype of aspirin to take.
Take anti-clotting medication.
People with stents are given prescription anti-clottingmedications, such as clopidogrel (Plavix). The American Heart Association and Foodand Drug Administration recommend that people who have had drug-eluting stentsinserted should continue to take medications, such as clopidogrel, to reduce the risk of  blood clots for at least one year after the stent is inserted. In some high-risk situations,your cardiologist may recommend taking clopidogrel indefinitely.
Listen to your cardiologist.
Always talk with your cardiologist about how long youshould take anti-clotting and other medications because the answer will varydepending on the nature of the your blockage and your risk of bleeding. The mostimportant thing to remember is to take all your medications exactly as your doctor  prescribes.
Talk to your other health care providers.
It's important to let your primary caredoctor and any other specialists you see know what medications you take and that youhave a stent. Anti-clotting medications and aspirin can affect surgeries and other medical procedures, and may interact with other medications.
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