Medication to help keep the arteries clear

After treatment to restore bloodA fluid that transports oxygen and other substances through the body, made up of blood cells suspended in a liquid. flow in the coronaryRelating to the arteries supplying the heart itself. vessels - reperfusionRestoration of blood flow through a previously blocked vessel. therapy - additional therapy must be given to help make sure that the arteries don't become blocked again. This is especially important as angioplastyThe mechanical widening or clearing of a narrowed or obstructed blood vessel, performed during angiography, which is used to help with visibility. can actually promote clot formation if bloodA fluid that transports oxygen and other substances through the body, made up of blood cells suspended in a liquid. vessels are damaged during the procedure.[1]

Medications that may be given to help to keep the arteries clear (or 'patent') include:[1,2]

  • Antiplatelet therapy, such as aspirin
  • Anticoagulants, such as heparinA substance produced by the body, or given as medication, that reduces the likelihood of the blood to clot, coagulate..

Antiplatelet therapy

Antiplatelet therapy with a drug such as aspirin should be administered as soon as possible after a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction.. If there are no side effects, aspirin should be continued indefinitely after a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction..[1-3]

Clopidogrel is another antiplatelet agent often given in addition to aspirin for up to 12 months after an attack.[3] Other, newer, antiplatelet agents may also be considered, such as prasugrel, a drug in the same class as clopidogrel, and glycoprotein IIb/IIIa inhibitors such as eptifibatide and abciximab, which are given intravenously for a short time to prevent platelets sticking together and causing clots.[1,2] Although they may be used in combination, taking more than one antiplatelet agent does not always give any additional benefit.[4]

Anticoagulants

As well as antiplatelet therapyTherapy to prevent the clustering of platelets (platelet adhesion) in the blood, so preventing the formation of clots. with aspirin or clopidogrel, anticoagulation with heparinA substance produced by the body, or given as medication, that reduces the likelihood of the blood to clot, coagulate. is also often recommended after a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction.. Heparin prevents clots from growing by inhibiting the action of several proteins that normally promote clotting.[3] Heparin may be given to prevent a recurrent heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction., and to lower the risk of complications. Another drug called warfarin may be given in some cases.[1,3]

References: 
  1. Diagnosis and management of ST elevation myocardial infarctionDeath of an area of heart muscle due to poor blood supply.: a review of the recent literature and practice guidelines.  Hahn SA and Chandler C. The Mount Sinai Journal of Medicine 2006;73:469-81.
  2. Boon NA, Colledge NR and Walker BR. Davidson's Principles and Practice of Medicine. Churchill Livingstone Elsevier. 2006; 20th edition.
  3. Unstable anginaA central chest pain caused by insufficient oxygen supply to the heart. and non-ST-segment myocardial infarctionDeath of an area of heart muscle due to poor blood supply.: an evidence-based approach to management. Kou V and Nassisi D. The Mount Sinai Journal of Medicine 2006;73(1):449-68.
  4. What is the role of dual antiplatelet therapyTherapy to prevent the clustering of platelets (platelet adhesion) in the blood, so preventing the formation of clots. with clopidogrel and aspirin? Bakhru MR and Bhatt DL. Cleveland Clinic Journal of Medicine 2008;75(4):289-95.