Prescription Delay Following Stent Implantation Is a Common and Deadly Problem

Following obtaining a stent, numerous patients delay or fail to fill their prescription for clopidogrel or an additional antiplatelet agent. Now, a study published in the Journal of the American Heart Association offers evidence that this issue is widespread and frequently leads to critical consequences.

Researchers analyzed information from all stent implantations performed in British Columbia from 2004 through 2006. In all, 15,629 stents had been implanted: 3,599 sufferers obtained at least one drug-eluting stent (DES), and 12,030 acquired bare metal stents (BMS) alone. Nearly a third of the sufferers in each stent group did not fill their prescription inside of three days soon after leaving the hospital.

A delay of 3 or more days in filling a 1st prescription for clopidogrel following hospital discharge was linked with considerable increases in the risk for death and readmission with MI at two years:

• DES group: 18% in the delay group versus 8% (hazard ratio, two., CI one.6 – two.six)


• BMS: 22% versus 8% (HR two., CI 1.8 – two.3)

The improved chance was most evident in the initial 30 days. Patients who by no means filled their prescription had the worst outcomes — DES individuals who by no means filled their prescription had a twelve-fold increase in the risk for death, whilst BMS patients had a 5-fold enhance.

The authors observe that medicine compliance is especially crucial following a stent implant: “The threat of coronary stent thrombosis appears highest in the early time period right after stent implantation and decreases in the subsequent weeks to months. This coincides with a period right away after hospital discharge when individuals often expertise problems with medicine compliance, the most typical concern being failure or a delay to fill a discharge prescription.”

“This research highlights the relevance of making sure patients have access to prescription drugs as quickly as they depart the hospital,” mentioned the lead author of the paper, Nicholas Cruden, in an AHA press release. “Even a delay of a day or two was linked with worse outcomes.”

Prescription Delay Following Stent Implantation Is a Common and Deadly Problem