Guidelines for stopping Anti-Platelet Agents before procedure.
Anti-Platelet Medication: {note}{formmenu: default=No; Yes; name=apm}{endnote}{if: apm==No}not taking any anti-platelet medication, such as a low-dose Aspirin preparation or Clopidogrel or Asasantin.{else}{note}Select Anti-Platelet Agent {endnote}{formmenu: name=anti_platelet_drug; Select Anti-Platelet Agent; Low-dose aspirin; Clopidogrel (Plavix or Iscover); Low-dose aspirin + Clopidogrel (Co-Plavix); Dipyridamole (Persantin or Asasantin)}{note}Reason for taking Anti-Platelet Medication:{formmenu: name=anti_platelet_reason; default=Select reason for taking Anti-Platelet Agent;IHD without coronary artery stents;IHD with coronary artery stents inserted over 12 months ago;IHD with coronary artery stents inserted within 12 months;Cerebrovascular disease;Peripheral vascular disease;NO recognised clinical indication for taking this treatment}{endnote} -> Guidelines about stopping anti-platelet therapy before and after procedure: {if: anti_platelet_drug == "Low-dose aspirin" and anti_platelet_reason == "IHD with coronary artery stents inserted within 12 months"}Do not stop low-dose aspirin before procedure - ONLY omit on day of procedure; restart low-dose aspirin on the next day after procedure.{elseif: anti_platelet_drug == "Low-dose aspirin" and anti_platelet_reason == "NO recognised clinical indication for taking this treatment"}Stop low-dose aspirin for 5-days prior procedure; restart low-dose aspirin 7 days after the procedure if biopsy specimens are taken; otherwise if no biopsy specimens are taken restart low-dose aspirin on the next day after procedure.{elseif: anti_platelet_drug == "Low-dose aspirin" and includes(["IHD without coronary artery stents", "IHD with coronary artery stents inserted over 12 months ago", "Cerebrovascular disease", "Peripheral vascular disease"], anti_platelet_reason)}Stop low-dose aspirin ONLY for 2-days prior procedure; restart low-dose aspirin on the next day after procedure.{elseif: anti_platelet_drug == "Clopidogrel (Plavix or Iscover)" and anti_platelet_reason == "IHD with coronary artery stents inserted within 12 months"}Discontinue Clopidogrel medication 7 days before the procedure & replace with low-dose aspirin; do not stop low-dose aspirin before procedure - ONLY omit on day of procedure & restart low-dose aspirin on the next day after procedure; restart Clopidogrel medication 7 days after the procedure (and stop low-dose aspirin) if biopsy specimens are taken; otherwise if no biopsy specimens are taken restart Clopidogrel medication on the next day after the procedure (and stop low-dose aspirin).{elseif: anti_platelet_drug == "Clopidogrel (Plavix or Iscover)" and anti_platelet_reason == "NO recognised clinical indication for taking this treatment"}Discontinue Clopidogrel medication therapy 7 days before the procedure. Restart Clopidogrel medication 7 days after the procedure if biopsy specimens taken; otherwise if no biopsy specimens are taken restart Clopidogrel medication on the next day after the procedure.{elseif: anti_platelet_drug == "Clopidogrel (Plavix or Iscover)" and includes(["IHD without coronary artery stents", "IHD with coronary artery stents inserted over 12 months ago", "Cerebrovascular disease", "Peripheral vascular disease"], anti_platelet_reason)}Discontinue Clopidogrel medication 7 days before the procedure & replace with low-dose aspirin; stop low-dose aspirin 2-days before procedure & restart low-dose aspirin on the next day after procedure; restart Clopidogrel medication 7 days after the procedure (and stop low-dose aspirin) if biopsy specimens are taken; otherwise if no biopsy specimens are taken restart Clopidogrel medication on the next day after the procedure (and stop low-dose aspirin).{elseif: anti_platelet_drug == "Low-dose aspirin + Clopidogrel (Co-Plavix)" and anti_platelet_reason == "IHD with coronary artery stents inserted within 12 months"}Liaise with cardiologist about the risk/benefit of discontinuation of one of the anti-platelet agents (discontinue dual anti-platelet therapy for 7 days prior to the procedure & continue with low-dose aspirin alone); omit low-dose aspirin ONLY on day of procedure & restart low-dose aspirin on the next day after procedure; restart dual anti-platelet therapy 7 days after the procedure if biopsy specimens are taken; otherwise if no biopsy specimens are taken restart dual anti-platelet therapy on the next day after the procedure.{elseif: anti_platelet_drug == "Low-dose aspirin + Clopidogrel (Co-Plavix)" and anti_platelet_reason == "NO recognised clinical indication for taking this treatment"}Discontinue dual anti-platelet therapy 7 days prior to the procedure & continue with low-dose aspirin alone; stop low-dose aspirin 2-days before procedure & restart low-dose aspirin on the next day after procedure; restart dual anti-platelet therapy 7 days after the procedure if biopsy specimens are taken; otherwise if no biopsy specimens are taken restart dual anti-platelet therapy on the next day after the procedure.{elseif: anti_platelet_drug == "Low-dose aspirin + Clopidogrel (Co-Plavix)" and includes(["IHD without coronary artery stents", "IHD with coronary artery stents inserted over 12 months ago", "Cerebrovascular disease", "Peripheral vascular disease"], anti_platelet_reason)}Discontinue dual anti-platelet therapy 7 days prior to the procedure & continue with low-dose aspirin alone; omit low-dose aspirin ONLY on day of procedure & restart low-dose aspirin on the next day after procedure; restart dual anti-platelet therapy 7 days after the procedure if specimens taken; otherwise if no biopsy specimens are taken restart dual anti-platelet therapy on the next day after the procedure.{elseif: anti_platelet_drug == "Dipyridamole (Persantin or Asasantin)" and anti_platelet_reason == "IHD with coronary artery stents inserted within 12 months"}Discontinue Dipyridamole (Persantin or Asasantin) treatment 7 days before the procedure & replace with low-dose aspirin; do not stop low-dose aspirin before procedure - ONLY omit on day of procedure & restart low-dose aspirin on the next day after procedure; restart Dipyridamole (Persantin or Asasantin) treatment 7 days after the procedure (and stop low-dose aspirin) if biopsy specimens are taken; otherwise if no biopsy specimens are taken restart Dipyridamole (Persantin or Asasantin) treatment on the next day after the procedure (and stop low-dose aspirin).{elseif: anti_platelet_drug == "Dipyridamole (Persantin or Asasantin)" and anti_platelet_reason == "NO recognised clinical indication for taking this treatment"}Discontinue Dipyridamole (Persantin or Asasantin) 5 days before the procedure. Restart Dipyridamole (Persantin or Asasantin) 7 days after the procedure if biopsy specimens taken; otherwise if no biopsy specimens are taken restart Dipyridamole (Persantin or Asasantin) on the next day after the procedure.{elseif: anti_platelet_drug == "Dipyridamole (Persantin or Asasantin)" and includes(["IHD without coronary artery stents", "IHD with coronary artery stents inserted over 12 months ago", "Cerebrovascular disease", "Peripheral vascular disease"], anti_platelet_reason)}Discontinue Dipyridamole (Persantin or Asasantin) 7 days before the procedure & replace with low-dose aspirin; stop low-dose aspirin 2-days before procedure & restart low-dose aspirin on the next day after procedure; restart Dipyridamole (Persantin or Asasantin) 7 days after the procedure (and stop low-dose aspirin) if biopsy specimens are taken; otherwise if no biopsy specimens are taken restart Dipyridamole (Persantin or Asasantin) on the next day after the procedure (and stop low-dose aspirin).{endif}{endif: trim=left}