Three Years for Plavix

I had my semi-annual checkup with my cardiologist earlier this week. The visit went very well as I approach the two-year anniversary of my heart attack, suffered July 20, 2006. My electrocardiagram was described as “better than ever’’ by Paraboschi, noting this was due “to the combination of your medication and staying active.’’

Thankfully all is going well. I do the most I can to take care of myself and even forget my heart contains three drug-coated stents. I do, however, consider myself both thankful and lucky to be able to write this piece on a weekly basis.

As our visit was concluding, my cardiologist asked me if I was having any problems with the Plavix I still take daily in conjunction with an 81-milligram aspirin.

“You haven’t had any unusual bleeding?’’ he asked.

“Not since over a year ago, when I was still on Coumadin,’’ I said, remembering not-so-fondly how my winter of 2006-07 included a few nosebleeds that sent me to the neighborhood ear, nose and throat specialist.

“Luckily, I have had no problem with the Plavix/Aspirin regimen.’’

I was then informed my cardiologists subscribe to the theory a patient who has been treated with drug-coated stents needs to stay on the Plavix/Aspirin protocol for three years, far beyond the American Heart Association guidelines stating a patient should be on the regimen for up to 12 months.

My cardiologists are familiar with Dr. Samin Sharma, the director of interventional cardiology at Mount Sinai Hospital in New York, who decided last fall to extend Plavix treatment to three years with patients who have been given drug-coated stents. Other opinions seem to agree with this reasoning, feeling, with some of the questions posed in some studies that mentioned drug-coated stents in the same breath of blood clots, it is better to be safe than sorry.

As a recovering cardiac patient, I would much rather be safe than sorry as far as any possibility of blood clots are concerned. Again, Plavix has worked quite well in my medicine regimen, but there are still situations that I have to look out for. For instance, my gums seem to bleed a little more easily, both at home and when I get my teeth cleaned at the dentist.

I also have been lucky not to have undergone any major surgery since my heart attack. Often Plavix has to be stopped before surgery due its anti-clotting properties.

Three years is a substantial time, but my cardiologists also subscribe to the theory that three years is not indefinite, but it. Until then, however, the drug is considered a major component in my recovery.

“If you are in a life-threatening situation involving emergency surgery, then maybe I will negotiate on Plavix,’’ my doctor once told me.

Yet, there are challenges with some patients as far as Plavix is concerned. At $4 a pill, it’s a pricey drug for many.

I know its importance, however. One bit I do remember the day of my heart attack was, in a lucid moment being wheeled from the cardiac catheterization lab to recovery, was a nurse putting four Plavix pills in my hand and telling me to “swallow these quickly.’’

He then added, “You’ll be taking these for awhile.’’

With an estimated 800,000 patients receiving drug-coated stents this year, I am a member of an ever-expanding club.