Coronary Artery Disease: Antiplatelet Treatment

If you have heart disease, one of the things you can do to help your heart is to take medicine that helps prevent your blood from clotting. This is called antiplatelet therapy.

Aspirin is the most common antiplatelet medicine. Your doctor may suggest that you take aspirin, another antiplatelet medicine, or both.

Why take antiplatelet medicine?

Antiplatelet medicine helps prevent heart attacks.

Heart attacks occur when blood flow to the heart is blocked. This usually happens because fatty deposits called plaque have built up inside the coronary arteries, which supply blood to the heart. If a plaque breaks open, the body tries to fix it by forming a clot around it. The clot can block the artery, preventing the flow of blood and oxygen to the heart and causing a heart attack.

Blood clots also can form on stents, which are small expandable tubes that are put in your coronary artery during angioplasty. They keep the artery open. Blood clots on a stent block blood flow and can cause a heart attack.

Antiplatelet medicine helps prevent blood clots in the arteries and on stents. This reduces the chances that you will have a heart attack.

Is the medicine safe?

These medicines make bleeding more likely. Talk to your doctor about your risk for bleeding, especially if:

  • You have stomach ulcers or have had bleeding in your stomach or another part of your digestive tract before.
  • You had a stroke caused by bleeding in the brain.

Things to avoid when you take antiplatelet medicine

  • Limit alcohol. Ask your doctor whether you can drink alcohol and how much you can drink. Drinking 3 or more alcoholic drinks a day while taking antiplatelet medicine increases your risk for liver damage and stomach bleeding.
  • Do not take prescription or over-the-counter medicines, vitamins, herbal products, or supplements without talking to your doctor first. Before you take any over-the-counter medicine, read the label. Many contain aspirin and could cause you to take too much aspirin.
  • Do not take prescription blood thinners (anticoagulants) unless your doctor has told you to.

Other concerns

  • Do not stop taking aspirin or another antiplatelet medicine without talking to your doctor first. Call your doctor if you think you are having a problem with your medicine.
  • Talk to your doctor before having a medical procedure, surgery, or dental work that may cause bleeding. Your doctor can tell you if and when you should stop taking your antiplatelet medicine before the procedure. Make sure you understand exactly what your doctor wants you to do.
  • Talk to your doctor before taking aspirin or another antiplatelet medicine if you are pregnant, are breastfeeding, or plan to become pregnant.
  • If you need to take a pain reliever, talk to your doctor about which one you should take.

When to call your doctor

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You have a sudden, severe headache that is different from past headaches.
  • You have symptoms of a heart attack. These may include:
    • Chest pain or pressure, or a strange feeling in the chest.
    • Sweating.
    • Shortness of breath.
    • Nausea or vomiting.
    • Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms.
    • Lightheadedness or sudden weakness.
    • A fast or irregular heartbeat.
    After you call 911, the operator may tell you to chew 1 adult-strength or 2 to 4 low-dose aspirin. Wait for an ambulance. Do not try to drive yourself.

Call your doctor now or seek medical care right away if:

  • You have any abnormal bleeding, such as:
    • Nosebleeds.
    • Vaginal bleeding that is different (heavier, more frequent, at a different time of the month) than what you are used to.
    • Bloody or black stools, or rectal bleeding.
    • Bloody or pink urine.
  • You have:
    • Ringing in your ears.
    • Problems with your vision.
    • Nausea.
    • Dizziness.
    • Rapid, deep breathing.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You have an upset stomach.
  • You have questions about aspirin or other antiplatelet medicines.