Post to this topic if you are
concerned that you may be experiencing an allergic reaction
(hypersensitivity) after a drug-eluting stent (DES) procedure.
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Archived Postings from 2008 (42):
My husband has been on Plavix since January
of 2008 after stent surgery. He has been suffering with a painful
and itchy rash and his skin is all blotched. We have exhausted our
general
physician, heart specialist and dermatologist. We are going to another
dermatologist in Boston hoping to get to the bottom of his rash.
We feel now it is either the Plavix or the medicated stent (Taxus Express
2 Paclitaxel-Eluting Coronary Stent System.) D., Londonderry, New Hampshire, USA, October 20, 2008
4 weeks post drug eluting stent placement,
I have developed intense itching over most of my body - including palms
of hands, soles of feet. My Cardiologist doesn't think I am having
a reaction to Plavix due to late onset of itching and he doesn't think
it is the stent because the stent that caused allergic reactions hasn't
been used for years? Does anyone have more information on the rare,
but
real, allergic reaction to stents? Mary P., Kalamazoo, Michigan, USA, September 3, 2008
My husband had 2 taxus drug eluding stents
put it 6 months ago. When does the drug wear off the drug eluding
stent? How long does this take? months,
years, etc.? Does anybody know, thanks. Stephanie, Louisiana, USA, August 3, 2008
A general note to all -- we are very interested
in seeing posts from patients who think they may be having some type
of allergic reaction after stenting. Such a reaction
may be due to a new medication that has been introduced, so that's
the first suspect. Patients should discuss this possibility with their
cardiologists. Another possibility is a metal allergy, and we've discussed
that a number of times. A third possibility is an unexplained and ongoing
reaction and in those cases we'd also recommend that patients contact
Angioplasty.Org specifically for information on the research study
being conducted in Texas. This phenomenon has not been widely studied
(this Forum is one of the few places on the internet collecting this
information) so most cardiologists will not be aware of it. You can
get more information by emailing: stent@angioplasty.org Angioplasty.Org Staff,Angioplasty.Org, August 1, 2009
I had a heart attack in October, 06. The
doctor performed an emergency catheterization and inserted 2 Cypher
Drug Eluting Stents on my RCA and insert another stent to my CX a few
days after the first 2 stents. A week after I was discharged, I went
back to ER again, I felt dizzy, weak, pain on my chest, leg and whole
body and some rashes and when I was hospitalized again for 3 days I
was told that my blood pressure was down around 70/48 and my pulse
was 45-50 per minutes, so they decided to took all my medicine away
and re-start each 1 at a time and the doctor took away the Toprol XL
and lipitor and I was discharged. But even after 2 months, I occasionally
felt like having another mini heart attacked when chest pain (sharp
pain) rashes break out, nausea, headache, tired, weak and dizziness.
There has been time that the rash broke out and the bubbles was as
big as gum ball from the street machine, and I had half of my face
swollen a couples times. I had been back to the Cardiologist and asked
if I might have Metal allergy and he told me , he NEVER HEARD of anything
like this and ask why am I wearing a necklace and have no issues. I
would like to participate in this Stent Allergy Study program and I
do need to make myself feel better. I have not been feeling all right
since the stents had been placed into my heart, please help. HT, Quincy, Massachusetts, USA, July 31, 2008
I am a 52 yr old male, who two weeks ago
had a drug eluting stent placed in my left coronary artery and my right
one ballooned. Feeling great two days later, I thought all would be
well, then I began having chest pains and trouble breathing. I went
right back into hospital and my cardiologist went back in to see if
all was well. He found my arteries were wide open and could not see
ne thing wrong. He mentioned I may have acid reflux, so we began looking
into that. In the meantime, i woke up at 2am a week after having the
stent put in, with rash, itching and swelling. It got so bad that my
mouth and eyes were two times the size. Again, I went into hospital.
They put me on steroids and Benadryl. The rash went away but the swelling
took a little longer. After the steroid treatment, my B/P dropped to
79/32. Gave me fluids and it slowly went back up. I was watched for
a couple hours, the dr. thought I may be allergic to the Plavix they
had put me on or the B/P medicine lisinopril. The dr. took me off those
and put me on ticlopidine and amlodipine. They also sent me home with
presc. for prednisone and hydroxyzine for the rash and swelling. They
work, but as soon as they wear off and I should take another... the
symptoms return. My cardiologist never mentioned anything about
a possible allergic reaction to the stent. What should I do now? N. Ganz, Rhode Island, USA, July 31, 2008
Following a failed triple bypass, in May
08 my mother (57 yr/white) had two Taxus stents put in. She left the
hospital on Tues, she did not have her Plavix on Wed, and then had
a heart attack on Thurs morning. One of her stents had closed. Of course,
all the medical professionals say it was b/c of her missing her Plavix
just one day (why is it you have to stop taking Plavix 5 days before
a medical procedure then?). Anywho, they opened the stent back up and
sent her home. She has been breaking out with rash/hives ever since.
Started on her left arm, and has completely covered her body thus far.
They initially took her off Ramopril and has been off it for 2.5 weeks,
and now they have taken her off of Plavix for a week now. As of yet,
no change with her rash. She also has shortness of breath, fever,sweating,
and extreme itching. This has been going on since
May. Tammy L., South Carolina, USA, July 20, 2008
Gail -- drug-eluting stents were not approved
in the U.S. until late 2003, so probably they are bare metal. Does
he have metal allergies? Angioplasty.Org Staff,Angioplasty.Org, July 19, 2009
My husband had two heart attacks in 2001
both times was stented. Ever since then he has episodes of allergic
reactions. We know it is not from medications because he stopped
all medications and still had the reactions. I don't know if his stents
were medicated or not. He carries Benadryl with him all the time. Gail B., Slaughters, Kentucky, USA, July 13, 2008
RG -- there are a number of references on
this Forum to patients with known or suspected allergies to nickel,
a component of surgical stainless steel. All package inserts for stents,
bare metal or drug eluting, contain language warning against implantation
in individuals with known allergies to any component of the stent,
and often specifies stainless steel and nickel, so this is not unknown.
Perhaps an allergist can help. Angioplasty.Org Staff,Angioplasty.Org, June 30, 2008
I have an allergy to nickel. I was not questioned
about metal allergies at the time of the first DES placement. Now
I have a possible diagnosis of COPD. I am using a nebulizer and Advair
as well as taking SINGULAR. I do have allergies but have not had
so
much trouble with my bronchi until Sept of 2007. I would like to
know how allergic reactions to nickel manifest themselves. Could my
breathing
problems be caused by reaction to the nickel in the DES? And if this
could be true what are the options? I know that DES placement is
for life. My question then is how long will I live if I am allergic
to
the stents? I would appreciate some answers although I understand
that this is not a forum for diagnosis. I am interested in any knowledge
that can be provided. I do not know how or what to ask my dr. I am
so worried that I am on anti-anxiety medication as well as 15 other
drugs. RG, Wisconsin, USA, June 24, 2008
I am writing about my mother who is 60 years
old. She has Heart Disease which is hereditary,Thyroid Disease and
is a diabetic who has extremely high sugar readings between 300-500
on a daily basis. This is the medication that she takes:Insulin-Humalog
75/25, Metropol, Crestor, Plavix, Mirapex and etc. She had heart attacks
which lead to having stents inserted, had a triple bypass surgery in
between and yet still having to get more stents. Every 4 to 5 months,
my mother's arteries become 90 to 100% blocked with having to get more
stents everytime which none of the cardiologists can figure out why
this is such a problem. Could you please tell me why this keeps occurring
every 4 months? The stents implanted are the Taxus-Eluding Type of
Stents. I know that my mother is allergic to the following medications:Keflex,
Sulfa, Tramadol, Nitropatch, Glucovance, Glucophage, Glyburide and
Provochol. She just recently had another heart attack on May 30, 2008
with found out the main arteries that were bypassed during her triple
bypass surgery, are dead and cannot be utilized in the future. The
explanation was that the triple bypass procedure was not effective.
She ended up getting two more Taxus Stents on May 30, 2008 and now
has a total of 10 stents. This moment, she is hospitalized again, but
with a severe case of a rash/ hives, her skin is hot like a sunburn
and miserable/ excessively itchy. The hospital keeps trying to counteract
the hives with some Benadryl which is not working. The rash is reaching
a critical stage and now I am wondering if the Taxus Eluding Stents
are causing the adverse reactions that she is experiencing? What tests
are out there that can be conducted to determine if this is the root
of the problem or so I can rule this possibility out? She also was
given Heparin -a blood thinner which she never had until May 31, 2008.
Could Heparin cause an intensive rash and hives along with a burning
sensation? Help I need some answers fast. Thanks. Melissa, New Castle, Pennsylvania, USA, June 7, 2008
Ken -- see our reply from May 20. Do you have
allergies to metal? This is something that an allergist can test for. Angioplasty.Org Staff,Angioplasty.Org, June 1, 2008
3 months ago I had a plain 316L stainless
steel Boston Scientific stent placed in my right artery. I take lopressor12.5
mg twice a day, altace 2.5 mg once a day, Plavix 75 once a day, zocor
40 mg once a day, synthroid 50 micrograms a day, a multivitamin once
a day and Darvocet N-100 as needed. I have developed a hyper sensitivity
in my hands and feet that has lately been moving into my forearms
that feels like my hands and feet are being rubbed across a screen
or nylon
stocking and I get this entire body feeling of tingling. It is driving
me crazy and I'm about at the end of my rope on this, because my
Dr. refuses to investigate anything, saying it's my nerves. I cannot
get
a new Dr. for special reasons. I am also getting a rash of pin point
redness dots on my forearms that is now spreading. Could it be the
stent? If so, can the stent be replaced? This is getting quite serious
for me, please respond as soon as you have the time. Also, my teeth
feel tingly when I brush them, just like my hands and feet feel.
I'm begging for help. Thanks Much. Ken S., Marshall, Minnesota, USA, May 26, 2008
Jeannie -- the amount of drug that is given
off (eluted) by these stents is pretty small, and pretty
localized -- much less than the dose level you'd get when taking
Taxol as an anti-cancer drug, for example. Which is not to say
you're NOT
having
a reaction. But this is hard to pin down. Perhaps other
meds?
Many heart patients are prescribed new meds when they are
diagnosed with
CAD -- perhaps one of your blood pressure drugs needs
adjustment? Angioplasty.Org Staff,Angioplasty.Org, May 21, 2008
I had a DES inserted into RCA April 4, 2008.
I had a 70% blockage in that one artery. All others are 20-30%. I am
a 61 y/o white female, retired RN. After the Cath, I came home the
next day. Dr. told me to "go back to normal activities" the following
day. I did. I normally walk every morning for 30 minutes before breakfast.
I was very short of breath! felt terrible, Checked my b/p when I got
home, it was 96/48. I rested. Same occurrence the next day. I called
the cardio, he told me nothing he did could have caused decreased b/p.
He was a little concerned about the SOB. I looked up the DES. Taxus
11 eluded [eluted] with Taxol and the side effects of Taxol. These
included SOB, Hypotension. I asked cardio he said no...the eluding
[eluting] process was minimal drug exposure. The SOB is minimal with
exertion, hypotension continues in afternoons. I have since had EKG,
Echo, Lab work to rule out clot. All OK. Possible allergic reaction
to stent?? Jeannie Jeter, Summerfield, Florida, USA, May 20, 2008
J.J. from UK -- here are some references to
warnings about implanting stents in patients with metal allergies.
The FDA warning is for all metal stents (bare and drug-eluting), not
just the examples quoted here. The same language is in both the Instructions
For Use (IFU) for the CYPHER drug-eluting stent (page 4) and from
the Directions
for Use (DFU) for the TAXUS drug-eluting stent (page 2): "Patients
with a known hypersensitivity to 316L stainless steel may suffer an
allergic reaction to this implant." and so on. The part of
the stainless steel alloy that seems to cause the allergy is nickel.
(Also, many metal surgical devices are made with Nitinol, a nickel-titanium
alloy). The tricky part here is the phrase "with a known hypersensitivity." How
such a condition becomes "known" is dependent on the patient
communicating this knowledge to the physician. Patients are supposed
to be questioned about allergies before a stent (or pretty much any
medical procedure) but this query ("are you allergic to metal?")
often gets lost in a long list of questions. Moreover, many patients
may not be aware of their condition. Does this mean every potential
stent patient should be given an allergy skin patch test? Angioplasty.Org Staff,Angioplasty.Org, May 20, 2008
Dear Forum -- Thank you for your support so
far. I am still trying to find out the make of stent that my mother
had fitted and also to convince the specialists that there is the possibility
of metal allergies and stents. In your post of 5th May 2008 you referred
to the FDA-mandated package inserts for All stents that urges caution
against implanting stents in patients with known allergies to nickel
and chrome. Could you please give me a reference for this info – i.e.
a document on the web that I can research further and pass on to the
specialists? My google searches so far have not been able to locate
anything (this could be due to me struggling because of my medical
ignorance!). Your support and advice is much appreciated. Many many
thanks. J.J., United Kingdom, May 19, 2008
Thank you so much for your reply to my enquiry.
Just this initial info that you have provided has given me the conviction
to pursue the matter further (my Mother had again to visit the emergency
Department of the hospital this week after suffering another trembling
attack – the Doctor examined her for neurological causes ie a series
of reflex tests which proved negative and they are investigating thyroid
blood tests). I have contacted my Mother’s heart specialist and asked
for details of the stent that has been fitted and have included details
of your response which hopefully will provide some justification for
exploring the possibility of an allergy. I will advise you of any response
I receive. In the meantime I would once again wish to express my gratitude J.J., United Kingdom, May 9, 2008
The stent
allergy study we are helping with concerns reactions to drug-eluting
stents, most likely to the polymer plastic coating. From the description
and history you sent in, it sounds like your mother has a known allergy
to chrome, or other metals. Chrome dental clasps are actually an
alloy of nickel and chrome. Nickel allergies have been well-documented.
Most stents are made of surgical stainless steel which contains nickel.
The FDA-mandated package inserts for ALL stents, bare metal and drug-eluting,
caution against implanting stents in patients with known allergies
to these metals.
Sounds like the doctors are saying the stent was "plastic-coated". That would
indicate a drug-eluting stent. Do you know the name or brand of the stent? Angioplasty.Org Staff,Angioplasty.Org, May 5, 2008
My mother, aged 75, has a history of angina
and had a stent fitted on 9th June 2007, at Sandwell District Hospital.
Since then she has spasmodically not been feeling well – her symptoms
include sickness, headaches, trembling. The most recent of these “turns” has
been today – she went to the hospital and had a full check on her heart
including an ECG, blood pressure etc. The doctors assured her that
her heart was fine. I have today started to research the possibility
of an allergic reaction to the stent – we have on numerous occasions
raised this with the Doctors but they have dismissed our theory. They
say it is nerves, or rheumatism or age etc. The reason why we think
it could be an allergic reaction is that my Mother’s symptoms are very
similar to what she suffered some 15-20 years ago – it transpired that
she had a reaction to a denture clasp fitting which turned out to be
chrome – when this was eventually removed she recovered rapidly. Until
that point she had suffered a general feeling of being unwell and unable
to participate in activities etc. The doctors have said that the stent
they have fitted is not metal but plastic coated – to what extent they
are certain of this I do not know – but given that my Mother is susceptible
to allergic reactions and I have discovered that some people do suffer
even when it is plastic coated I feel it is worth pursuing this line
of enquiry. Especially given the impact of the general feeling of constantly
being ill is having on my Mother’s general well being and making her
so depressed given that normally she is an exceeding young and active
75 year old. I would very much welcome any information/advice that
you can provide. Many thanks. J.J., United Kingdom, May 2, 2007
Deborah and Niloofar -- as we've noted before,
very little is known about hypersensitivity reactions to drug-eluting
stents -- and one of the confounding issues is that patients with stents
are also patients who take a number of different medications, each
of which has its own set of adverse or allergic reactions. Also, because
these reactions are small in percentage, it is very difficult (and
expensive) to run large enough studies that will yield valid data.
Two cardiology groups in Texas and Chicago are studying this (see "To
Patients" notice in the right column). What they do is remove
each medication (substituting a different one) to rule out drug reactions,
and then do a skin patch test with small pieces of the various stents.
If the skin reaction is positive, there is a high likelihood of allergy
to some part of the stent (it is thought that the polymer-coating is
the culprit). One option is to visit an allergist to see if a drug
you are taking might be the cause. As for a fever and rash two years
after stent implantation, probably unlikely -- and certain antibiotics
are known to cause rashes in some people. Angioplasty.Org Staff,Angioplasty.Org, May 2, 2008
I have a problem that I haven't read here.
I had 2 medicated stents inserted in Feb of 05. 10-12 days later I
had several canker sores in my mouth. At the time I was 53 Years old.
Before then I may have had 2 or 3 in my entire life. Ever since then
I've repeatedly had 1 or up to 3 in my mouth. After it heals I get
another. I am seldom without them. Is this some kind of reaction to
the stent (or Plavix) or did I pick up something in hospital. Help!! Deborah, Alabama, USA, April 26, 2008
Greetings, My Dad is 82 years old and had
two DES put in his heart, two years ago. Few weeks ago he caught the
flu and a week after he was recovered, he had high fever for 24 hours
and was put back on antibiotics, which led to having rashes. Could
the rash and fever be a reaction due to the DES? I appreciate any feedback.
P.S.: he is taking plavix, metoprolol, lipitor, flomax, Nexium. Niloofar Yekani, Connecticut, USA, April 15, 2008
Debbie and Sue -- we have sent you information
about the stent hypersensitivity study being conducted in Texas and
Chicago. if you browse around this toipic, you'll see a range of unexplained
symptoms that patients have reported to us, symptoms that started after
a stent was implanted. There are 4 possibilities:
reaction to a prescription
drug started at the same time as the stent;
reaction to the drug-eluting
stent itself (most likely to the plastic (polymer) coating);
reaction the the metal in
the stent; and
reaction is unrelated to any
of these and is coincidental.
Many patients report that their physicians believe
this last explanation is the most likely, But given the number of postings
here and the similarity in symptoms, we disagree and think that the
last explanation is the least likely. Drug and metal reactions
can be tested for by an allergist. If they don't exist then a possible
explanation is a reaction to the drug-eluting stent. The study being
done by the Texas and Chicago hospital does exactly this -- they eliminate
other causes step-by-step and then administer a skin patch test, using
a small part of an actual stent. They report to us that they are definitely
seeing a correlation between positive patch tests, symptoms and inflammation
at the stent site. The reason most doctors are unaware of this possibility
is that there have been no studies published on the topic. The study
we are involved in is the ONLY one of its kind, to our knowledge. Angioplasty.Org Staff,Angioplasty.Org, April 11, 2008
My mom had a Cordis stent put in in January
08. Immediately after she started to complain of intense pain in shoulders & arms & wrists.
Her hands went numb & were so pained she would go days without
sleep. Shortly after that both her knees blew up & were very painful.
She is not able to get up from a sitting position. she is on Plavix.
She was diagnosed with carpel tunnel in both hands & had surgery
on one so far. The pain has subsided in that hand but not the tingling & numbness.
Her cardiologist insists this is not relayed to the stent or the plavix.
i am finding it harder & harder to believe. can you please furnish
me with as much information as you can on side effects of medicated
stents & plavix. i forgot to mention she took Vytorin for a month
after surgery as well. My mom's health was great before this stent.
I suspect she is rejecting it. Any help would be appreciated. Thank
you Sue, Florida, USA, April 5, 2008
My mother had two stents placed in her heart
in January 2008. She has had severe nausea EVERY DAY since then. She
had congestive heart failure but never had any stomach problems before.
The doctors have done many many tests and have given her every kind
of medication. She is now on the medication given to chemo patients
for nausea and she sleeps all the time or is very sluggish when awake.
Her quality of life is GONE. We were not told of any side effects at
all before the stents were put in. The doctors are very indifferent
about this problem and act as if it is a total mystery to them and
they have never heard of this reaction!! Please let us know what can
be done!!!!!!!!!!! Debbie N., Indiana, State, USA, March 30, 2007
Brian -- hard to say, which is why we're sending
you information about the drug-eluting stent study being done in Texas.
One of the protocols is to take patients off of each drug (using an
appropriate substitute) and once that's been done and the symptoms
remain, they use a skin test to see if there might be a reaction to
the drug-eluting stent material (not so much the metal, but the polymer/drug
combo). Read our article "Drug-Eluting
Stents May Cause Allergic Reactions" about a study published
two years ago -- this is still a little-understood syndrome and, as
newer drug-eluting stents come on the market, may change. Hope this
helps. Angioplasty.Org Staff,Angioplasty.Org, February 3, 2008
I am a 45 year old male. On Dec 26, 2007 had
one Taxus Express 2 drug-elating stent placed in the circumflex (which
was 80% they also say I had a 100% that fixed itself). Upon discharge,
I was placed on Plavix 75 mg., Metoprolol Succinate ER 25 mg., Lipitor
80 mg., Altace 2.5 mg., Ecotrin 325 mg.. all once a day. (prior to
stent placement only meds I was taking was Lipitor 20 mg and Ecotrin
81 mg Once a day) Had no hypertension issues and cholesterol on Lipitor
was about 140 (good cholesterol was a little low)
I informed the Cardiologist I was against such a
raise in the Lipitor (from 20-80) he stated it was just for 2 weeks,
well after 2 days I could feel the pains in the lower back and the
legs, I called him and immediately put myself back down to 20mg. This
was on 12/29/07.
Went back to work as Bus Operator on 1/10/08, everything
was fine until 1/21/08, At the end of my shift, My arms, elbows, wrists,
hands, fingers, knees, and ankles were very painfully swollen and sore.
I had to go the the emergency room, they drew blood and told me it
was probably an allergic reaction from the Altace (ACE inhibitor).
The E.R. gave me an I.V. with Benadryl, Steroid and pain killer, went
home 3 hrs later feeling fine. Stopped taking everything except Plavix
and Ecotrin on 1/22/08. Stayed home until 1/25/08 went back to work
and at the end of my shift, the same thing happened with all the same
muscles and joints swollen and painful. Saw the Cardiologist on 1/28/07
he placed me back on the Metoprolol and lowered the Ecotrin to 160
mg. While still badly swollen, I saw my PCP on 1/30/08. He also agreed
that this more than likely is a reaction from the ACE inhibitor He
placed me on Prednisone 20mg and Benadryl 25mg once a day and return
to Lipitor 20 mg. and lowered the Ecotrin to 81 mg.. This seemed to
clear everything up. So I went back to work on 1/31/08 with the same
results, at the end of my shift at night all the same muscles and joints
became swollen and painful. I went back to my PCP and he raised the
Prednisone to 60 mg. for 2 days than 40 mg for 2 days than 20 mg for
6 days. He also suggested that I change the Metoprolol to Coreg CR.
I'm going to take the next 7 days off to rest the muscles and joints
than try to go back to work.
I've been doing a lot of internet surfing in my free
time at home, nobody seems to be definitely positive that it is the
ACE inhibitor, The E.R. said it could take a couple of weeks for the
ACE inhibitor to clear out, is this true?.I'm afraid it might not be.
Could it be the DES or one of the other drugs (never had any problems
with Lipitor) I been pretty healthy and active all of my life, playing
racquetball once a week, mowing the lawn, swimming etc.. I'm new at
this and quite concerned about what my next step should be if this
problem persists. Help!! Brian G., New York, USA, February 2, 2008
A. Gregory -- aches and joint pains are a
known side-effect of statins. You should discuss this with your cardiologist
-- perhaps other methods of lowering cholesterol can be an adjunct..
Let us know what he/she recommends. Angioplasty.Org Staff,Angioplasty.Org, February 2, 2008
I have been taking Plavix, Hyazaar, Herbessor,Vasteral
and Lipitor. I am a 58 year old female. I get a lot of aches and pains
almost everyday but I need to get my Cholesterol down so I continue
with taking Lipitor. Lovastatin also does the same thing but it does
not lower the Cholesterol. In the long run is it harmful if I carry
on with the Lipitor? A.Gregory, Malaysia, January 29, 2008
R.G. -- we can't give any specific medical
advice, but you're definitely doing the right thing by meeting with
your cardiologist about your drug regimen. Sounds like the statins
might have been causing problems, but again -- this is something only
your doctor should advise you on -- not us, or any internet site! We've
definitely heard a lot from people with nickel allergies -- we've not
found any medical literature definitively stating that this can cause
serious reactions, but the cautions DO exist in the "Instructions
for Use (IFU)" mandated by the FDA, so there must be some evidence. Angioplasty.Org Staff,Angioplasty.Org, January 29, 2008
My
list of medications include two statins atenolol, cozaar, Lasix,
another blood pressure medication and 2 medications for acid reflux.
I have just recently stopped the statins. The docs adjusted the statins
down to an every other day administration. But I have felt so much
better on the days that are absent the statin that I have taken an
occasional extra day off of the med. This last weekend I decided
not to take the statins (Zetia and Pravachol) and am able to get
out of bed and have noticed less pain. I will be addressing this
change with my physician. I was not asked about anything but medication
or food allergies. I remember because on a later hospitalization
I added nickel to my list. Statins are on the list. What are options
for my predicament? R.G., Wisconsin, USA, January 29, 2008
Valerie -- stents cannot be "removed" once
placed. But drug-sensitivity to Plavix is a known problem (rash, etc.).
Read over our Forum Topic on Plavix
and Stents. There is information there that may sound familiar.
As for dealing with this situation, several groups have published papers
on desensitizing allergic reactions to Plavix -- one in Iowa and also
at Scripps in La Jolla. We'll soon be posting an exclusive interview
with Dr. Karl von Tiehl of Scripps, lead author on a paper published
in the November 5 issue of the Journal of the American College of Cardiology,
titled "Clopidogrel
Desensitization After Drug-Eluting Stent Placement". In this
paper, which you might want to show to your cardiologist, Dr. von Tiehl
describes the protocol for desensitization which, he tells us, is one
which any qualified immunologist familiar with the area of drug desensitization
should be able to carry out. If you or your doctor have further questions,
feel free to post here, or even call Scripps. Good luck and let us
know how you fare. Angioplasty.Org Staff,Angioplasty.Org, January 29, 2008
My dad (75, quadruple bypass 5 years ago)
had angioplasty 3 weeks ago and had one DES put in for a significant
blockage in 1 artery. He was put on Plavix but seemed to have an allergic
reaction (itchy rash on chest) and was then put on Ticlid He's now
experiencing a worse itchy rash. His cardiologist had said before there
was no alternative to taking one of these 2 drugs for at least 5 months,
that Coumadin and aspirin wouldn't work for this. How can we find out
for sure if he's allergic to these medicines, or something in the stent
itself, or maybe even the dye used in the angiogram? And if he is allergic
to both medicines, what can be done? Remove the stent and put in a
bare metal one? Another bypass? Valerie M., New York, USA, January 29, 2008
R.G. -- yes, pretty
much all stents (drug-eluting AND bare metal) contain nickel and the
FDA package insert / instructions for these clearly state that the
device should not be used (or used with caution) in patients with known
hypersensitivity to any componet of the stent. The tricky part here
is the "known hypersensitivity" (a.k.a. "allergy")
-- patients are supposed to be asked about allergies, etc. but we've
found that many patients report not having been queried about this
-- or they don't realize how important this information can be. It's
also not clear as to how severe such a metal allergy can be (the stent
is quite small). Are you taking other meds? For example, joint pain
is a known side-effect of statins. But definitely see your cardiologist
about your reactions -- he/she should be able to offer you some information
and help. Let us know what you find out. Angioplasty.Org Staff,Angioplasty.Org, January 20, 2008
I wonder if I am allergic to Plavix? My symptoms
include stomach upset, shortness of breath, severe pain in ankles and
wrists. I am lactose intolerant and I have read that Plavix tablets
contain lactose. I am allergic to nickel and I have read that taxus
stents contain nickel. I would like to know if this is true and how
should I approach the possibility of allergic reaction with my cardiologist
or my family physician. I have had 4 stents placed in my RCA and D1
and continue to be semi bed ridden. What do you suggest? R. G., Wisconsin, USA, January 18, 2008
I am a 56 year old female that has recently
(Nov.2007) had a Taxus Drug Eluting stent put in my LAD artery that
was 99.9% blocked. I also had an angioplasty done on a smaller artery
at the same time. I was involved in a car accident on Aug.11th, 2007,
no fault of my own, this accident caused a major back problem that
I was scheduled to have surgery on Nov.29th 2007. I began having chest
pains, some worse than others, that concerned me enough to see my family
Dr. He did an ekg, showed a problem, had a stress test which also showed
a problem. My Dr. sent me to see a cardiologist in Joplin Missouri.He
did an echo-cardiogram and found the problems. He never told me that
my condition was life threatening, but he did tell my husband that
the front part of my heart was barely getting any blood or oxygen to
it. Had my heart work done on Nov.26th, 2007. the first thing I noticed
immediately, was that my breathing was sooo much better!!! I felt wonderful
until 4-5 days after my procedure. Then, all hell broke loose. I developed
a itchy red rash like I have never experienced before! I still have
scars where I scratched so hard. My Dr. gave my a 6 day series of a
steroid pill which got rid of it. I guess I'll never know the cause
of the rash, I thought it might have been the white contrast dye that
was used to find the blockages. Since then, I have never felt better.
My cardiologist was a gift sent from God, as I was so close to having
a heart attack. Ironic, how an auto accident actually saved my life.
I think the stress of the wreck is what started these angina pains,
the pains are what made me get checked out. I feel like the Taxus stent
has given me a 2nd chance at life. I feel great!!! Thank you, thank
you, thank you to Dr. Robert Stauffer, Freeman Heart Institute Joplin
Missouri....... Norma Wilkes, Afton, Oklahoma, USA, January 14, 2008
My name is Ken and I posted on this site in
Oct/Nov of2006. In Aug 2006, I was given a cypher stent. I had 3 previous
bare metal stents with no problem. I had refused the cypher stent,
declined it in writing in 2004 when it was brand new, as I have a severe
allergy to all Mycin drugs and their derivatives, This was clearly
noted on my charts and records at the hospital and with my Dr. also
on my allergy wrist band. 1 week after implant of stent I was readmitted
with severe pain and blood pressure at 240/127. Re-catheterization
showed the stent was still in place but during procedure I went into
full arrest. Did I mention that I also have a pacemaker from 2005.
I survived and wished that I had not. I lived with severe pain for
several months and slowly regained some signs of life as the drug wore
off. Problem came back in august 2007, and my NEW TEAM of specialists,
did not feel that the stent was the problem. Back into cath lab and
two more stents BMW were placed in to relieve recurring pain and weakness
in left side. November I began to fail badly. BP out of control with
any medications, back into hospital emergency room late november. Diagnosis
was restenosis 95% or more in the medicated stent. Also showing some
muscle damage to heart. Overworking? Bottom line on Monday 1/14/08
I will be back in again for bypass surgery to the blocked gx--ffd cypher
stent. Never, Never Never risk a medicated stent. Be aware that Drs
make more money using them and there is no way that I will ever believe
that my first Dr was acting in my best interest. When I said no medicated
stents I thought it meant forever. His lawyers argue no. With my other
problems, I will survive this ordeal ONLY BY THE GRACE OF GOD... I
TRUST IN HIM and No-one else. I did report this to the texas team doing
the study and heard nothing. I wonder who is paying their bills. My
bills for health last year $175,000.00 20% out of pocket. Ken Feeley, Bonita Springs, Florida, USA, January 12, 2008
Jackie -- the red rash is often a sign of
allergy to a drug, usually Plavix -- but your aunt should NOT stop
taking Plavix -- it's critical after stenting to stay on antiplatelet
therapy to avoid clotting. One question: did your aunt begin any new
drugs at the same time as the stent placement? These might be one cause,
but she should certainly see her interventional cardiologist and discuss
these symptoms with him/her. You might also email us at the address
in the sidebar (under the "DONATE" button) to get some information
on the stent allergy study being conducted in Texas. Angioplasty.Org Staff,Angioplasty.Org, January 11, 2008
I have an Aunt in Arkansas and she had drug
eluting stents (6 months ago). She started the day she had them with
vomiting, then she began to break out all over her body with a red
rash and itching. She has been to all kinds of doctors and has continually
gone down hill. She is very weak, has very low blood pressure. She
was doing well until the stents were placed in her. She now has begun
to have kidney and bowel problems. Do you know if she needs to go to
an allergy doctor to find out if she is allergic to the stents or the
medication in the stents? Jackie, Millington, Tennessee, USA, January 8, 2008
Plavix and Aspirin Resistance is another Issue.
If the Plavix fed bleeding Ulcer don't kill ya then your dual antiplatelet
the rapists oops (therapy) aint workin because as many a 1/3rd tested
on such may be resistant to Plavix and aspirin see Accumetrics VerifyNow
to get tested, Then ask your doc why he didnt test before. stent clots x 3 and counting , realist, Florida, USA, January 7, 2008