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Antiplatelets: 1 person, 1 dose?
Date:4/14/2011

Montreal, April 14, 2011 An international consortium of scientists, including major contributions from the Montreal Heart Institute, demonstrates that the "one-size fits all" strategy of uniformly doubling the dose of an antiplatelet drug, clopidogrel, for patients with high on-treatment platelet reactivity does not reduce the incidence on death, heart attacks and stent thrombosis after percutaneous coronary intervention (PCI). The results of the GRAVITAS trial conducted to determine whether high-dose clopidogrel is superior to standard-dose therapy for the prevention of cardiovascular events after percutaneous coronary intervention in patients with high on-treatment reactivity, have been published recently in the Journal of the American Medical Association.

The GRAVITAS (Gauging Responsiveness with A VerifyNow assay Impact on Thrombosis And Safety) study showed no benefit of double-dose compared with standard-dose clopidogrel and the results refute the strategy of uniformly doubling the dose of clopidogrel over six months for patients with high on-treatment platelet reactivity after PCI with drug-eluting stent. In the multicenter, randomized, double-blind, active-control trial, the use of high-dose compared with standard-dose clopidogrel did not reduce the incidence of adverse cardiac events such as death, nonfatal myocardial infarction or stent thrombosis.

"The results of GRAVITAS are surprising because they do not support a uniform treatment strategy of high-dose clopidogrel in patients with high on-treatment reactivity." said Dr. Jean-Franois Tanguay, interventional cardiologist at the Montreal Heart Institute, professor of medicine at the Universit de Montral and lead investigator in Canada. "Personalized medicine merits further investigation. We need to assess alternative treatment strategies incorporating platelet function testing as opposed to prescribe a fixed, higher dose."

Between July 2008 and April 2010, 2214 pat
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Contact: Julie Chevrette
julie.chevrette@icm-mhi.org
514-376-3330 x2641
Montreal Heart Institute
Source:Eurekalert

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