Navigation Links
Clopidogrel reloading worthwhile in acute coronary syndromes
Date:4/1/2008

CHICAGO, Ill. (April 1, 2008) Many patients who come to the cardiac catheterization laboratory for percutaneous coronary intervention (PCI) are already taking 75mg of clopidogrel daily to prevent unwanted blood clotting. Even so, an additional 600-mg reloading dose of clopidogrel significantly improves clinical outcomes without increasing the risk of bleedingbut only in patients with acute coronary syndromes (ACS), according to the Antiplatelet Therapy for Reduction of Myocardial Damage During Angioplasty-RELOAD (ARMYDA-RELOAD) study.

The study is being presented today in a Late-Breaking Clinical Trials session at the SCAI Annual Scientific Sessions in Partnership with ACC i2 Summit (SCAI-ACCi2) in Chicago. SCAI-ACCi2 is a scientific meeting for practicing cardiovascular interventionalists sponsored by the Society for Cardiovascular Angiography and Interventions (SCAI) in partnership with the American College of Cardiology (ACC).

The ARMYDA-RELOAD study found that clopidogrel reloading reduces the combined risk of death, heart attack or repeat coronary procedure by nearly two-thirds in patients with ACS, although it offers no benefit to those with stable chest pain. Until now, no study has ever specifically examined the effect of clopidogrel reloading on patients with acute coronary syndromes, a condition that encompasses both unstable angina and a form of heart attack known as non-ST-segment-elevation myocardial infarction (NSTEMI). Clopidogrel is used to prevent the formation of blood clots, or thrombi, which could block the coronary artery and cut off blood flow to the heart muscle.

The implications of the study are self-evident: When a patient with ACS is undergoing PCI and has been taking clopidogrel before, it is a very good idea to give a further loading dose of 600 mg prior to the procedure. This will protect against ischemic complications, without fear of more bleeding, said Germano Di Sciascio, MD, professor and chairman of cardiology at Campus Biomedico, University of Rome, Italy. In patients with stable syndromes, ongoing preexisting clopidogrel may supply sufficient anti-platelet effect to safely undergo the procedure.

For the study, Dr. Di Sciascio and his colleagues recruited a total of 436 patients who had been taking clopidogrel for more than 10 days before PCI. Of these, 167 (38 percent) had ACS. Patients were randomly assigned to receive an additional 600-mg loading dose of clopidogrel four to eight hours before PCI or to receive a placebo. Blood tests confirmed that platelet reactivity was significantly lower in the reload group when compared with the placebo group in patients with ACS.

After 30 days follow-up, the overall rates of major adverse cardiac events (MACE)consisting of death, heart attack, or repeat PCI or bypass surgerywere the same in the two groups: 7 percent in patients who received clopidogrel reloading vs. 9 percent in the placebo group (p=0.70). A similar finding was observed in patients with stable chest pain (8 percent vs. 4 percent, respectively, p=0.23). However, in patients with acute coronary syndromes, clopidogrel reloading significantly reduced the MACE rate (7 percent vs. 18 percent, respectively; odds ratio: 0.36; p=0.035). There was no difference in the rates of bleeding (5 percent in both groups).

Fundamental differences in the cardiovascular conditions that characterize acute and stable chest pain may explain the effectiveness of clopidogrel reloading in patients with ACS, Dr. Di Sciascio said. Patients with ACS have higher platelet reactivity, higher inflammatory status and more intracoronary thrombus, he said. This may make them more prone to benefit from clopidogrel reloading.

Dr. Di Sciascio will present the results of the "Antiplatelet Therapy for Reduction of Myocardial Damage During Angioplasty-RELOAD (ARMYDA-RELOAD) study on Tuesday, April 1 at 11:30 a.m. CDT in the Grand Ballroom, S100.


'/>"/>

Contact: Kathy Boyd David
pr@scai.org
717-422-1181
Weber Shandwick Worldwide
Source:Eurekalert

Related medicine news :

1. Daiichi Sankyo, Lilly Announce New Prasugrel Head-to-Head Phase III Study Against Clopidogrel
2. In Landmark Phase III Head-to-Head Study, Prasugrel Statistically Superior to Clopidogrel in Reducing Risk of Heart Attack
3. Half of patients undergoing cerebrovascular stent placement respond poorly to clopidogrel
4. Matrix registry probes adherence to clopidogrel at 1 year
5. Diabetes appears to increase risk of death for patients with acute coronary syndromes
6. Keane Wins $1 Million Electronic Medical Record (EMR) Implementation at New Jersey-Based Acute Care Facility
7. Study shows insurance status, not race, linked to complications in patients with acute appendicitis
8. FDA Approves LEVAQUIN(R) Short-Course Therapy for Treatment of Complicated Urinary Tract Infections and Acute Pyelonephritis
9. Acute lung injury patients one-third less likely to die in closed model ICUs
10. Stereotaxis Highlights New Data on Acute Success in AFib Treatments With Niobe Magnetic Navigation System
11. Short-term hemofiltration is cost-effective for severe acute pancreatitis
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:1/18/2017)... ... 18, 2017 , ... Catalent Pharma Solutions, the leading global ... health products, today announced that Mr. Michael Merges, Director of Strategic Growth, Catalent ... held at the Mayflower Hotel, Washington DC, on Jan. 24 – 26, 2017. ...
(Date:1/18/2017)... ... January 18, 2017 , ... Floundering on New Year’s ... and the perfect time for a reset. The U.S. Apple Association agrees and recommends ... many of the factors that contribute to heart disease. , The U.S. Apple Association ...
(Date:1/17/2017)... ... January 17, 2017 , ... For breast cancer clinicians and ... or those who desire a more intimate review and analysis of its highlights, a ... to Bedside—is being offered by Imedex on February 4, 2017 in Chicago. Chaired by ...
(Date:1/17/2017)... ... January 17, 2017 , ... Etymotic ... National Association of Music Merchants (NAMM) winter trade show, Booth #2876, at the ... ER•4® has long been the gold standard for high-definition, in-ear earphones. This classic ...
(Date:1/17/2017)... ... January 17, 2017 , ... Peoples Health is ... Health network on Dec. 1, 2016. Peoples Health, a Metairie-based Medicare Advantage company, ... an exciting addition to our provider network, and the addition will benefit our ...
Breaking Medicine News(10 mins):
(Date:1/18/2017)... , Jan. 18, 2017  Dermata Therapeutics, ... products to treat a variety of dermatological diseases, ... compound DMT210, in a Phase 2 acne rosacea ... to downregulate the proinflammatory cytokines in the skin ... acne rosacea. This clinical trial, ...
(Date:1/18/2017)... 18, 2017 The report " Automated Breast Ultrasound System ... Scanner), By End User (Hospitals, Diagnostic Imaging Centers), Industry Analysis Report, Regional Outlook ... Argentina , Germany , UK, France ... Russia , China , Japan , ... , Saudi Arabia , UAE, South Africa ...
(Date:1/18/2017)... , Jan. 18, 2017  Tarix Orphan LLC today ... granted a Rare Pediatric Disease (RPD) designation for the ... Dystrophic Epidermolysis Bullosa (RDEB), a rare genetic skin disorder. ... treatment is limited to supportive care. "The ... Drug Designation previously granted by the FDA in this ...
Breaking Medicine Technology: