I have finished Cardiovascular Fellowship in 1994. I have been practicing medicine for over 25 years. I have seen many medications initiated and many have survived the last 25 years. Some have not. Adding aspirin as an antiplatelet therapy after angiplasty /stent began 30 years ago. I was there. Two studies in that era, the CREDO and CURE trials showed the benefits of adding clopidogrel ( plavix) to aspirin versus aspirin alone after stent or myocardial infarction ( heart attack) forming what we know now as dual platelet therapy. Some later studies revealed some ischemic events after discontinuation of ant platelet therapy. This then favored the use of platelet therapy for at least twelve months, This 12 month therapy is reflected in the guidelines. I am not opposed to such therapy
To decide which anti platelet drugs to use is by the discretion of the physician and his/her comfortability with the drugs. Whether it is Eliquis, Brillanta, Xarelto, Plavix or other drugs. It is always decided what to add to aspirin. I tell you all this as it isn’t easy for the physician to make this decision.
Recently an article in the American Journal of Cardiology entitled “ Optimizing Monotherapy Selection, Aspirin versus P2Y12 inhibitors following Percutaneous Intervention was published. I found the artocle to be useful at selection of which therapy.
There are also many herbs and supplements that can thin blood. Many of these have not been studied in double blind clinical trials. Many of my patients ask about these therapies. These are omega 3 oils, ginkgo, garlic, nattokinase and many more.