Navigation Links
Double-Dose Plavix Benefits Certain Patients, Study Finds
Date:9/1/2010

By Steven Reinberg
HealthDay Reporter

WEDNESDAY, Sept. 1 (HealthDay News) -- More isn't necessarily better when prescribing the two drugs commonly used to treat patients who are in danger of having a heart attack, Plavix (clopidogrel) and aspirin, a new study suggests.

Two reports on the data find that high doses of Plavix are good for some patients, but not all, while high-dose aspirin is no better than a low dose for preventing new heart attacks, other cardiac problems, stroke and death.

The findings suggest a need to assess the risks and benefits individually, experts say.

Patients who are at high risk for heart attack and stroke and low risk for bleeding are going to do well on a higher dose of Plavix, said Dr. Gregg Stone, author of an editorial in The Lancet.

"Patients who are at lower risk for atherosclerotic complications, but high risk for bleeding should be treated with a more conservative lower dose," added Stone, director of cardiovascular research and education at Columbia University Medical Center in New York City.

The reports are being released Wednesday to coincide with the meeting of the European Society of Cardiology in Stockholm. They are also published in the Sept. 1 online edition of The Lancet and in the Sept. 2 issue of the New England Journal of Medicine.

While aspirin and Plavix are mainstays of treatment for those at risk of having a heart attack, questions remain about proper dosing. Too little medicine won't prevent clotting, which can lead to heart attack, while too much can cause fatal bleeding.

To assess the best treatment regimens, the researchers assigned 25,086 patients at risk of having a heart attack (due to acute coronary syndrome) to a standard dose or double dose of Plavix and to high- or low-dose aspirin. Patients on the standard dose of Plavix got 300 milligrams (mg) the first day followed by 75 mg daily, while those with the double dose took 600 mg on day one, followed by 150 mg for six days and 75 mg thereafter. Patient outcome was evaluated after 30 days.

About two-thirds of the patients underwent percutaneous coronary intervention (PCI), also known as angioplasty. This involved threading a catheter with a balloon at the end through a blocked or narrowed coronary artery and placing a small mesh tube, called a stent, in the artery to keep it open.

After angioplasty, patients typically receive both Plavix and aspirin to reduce the likelihood of clotting and re-blocking the artery or the stent.

The researchers found that patients undergoing angioplasty benefited from a double dose of Plavix, with their risk of heart attack, stroke or death reduced 14 percent, compared with patients who were given a standard dose. Moreover, the risk of clotting in the stent was cut 46 percent among those receiving the double dose.

However, the double-dose patients had a 41 percent increased risk of bleeding compared to those getting the standard dose. This led the researchers to recommend a standard dose for patients not having angioplasty.

As for aspirin, no difference in adverse events was seen among patients taking a high (300 or 325 mg) or low (75 to 100 mg) dose. The researchers concluded that low-dose aspirin is best, since it reduces the risk of bleeding without increasing the risk of clotting.

"Taken together, the message is very simple: We recommend that patients undergoing PCI receive the full double-dose regimen of clopidogrel, and those who do not have PCI should be treated with the standard-dose regimen of clopidogrel," said Dr. Shamir Mehta, an associate professor of cardiology at McMaster University in Ontario, Canada, and co-author of both reports.

Commenting on the study, another expert, Dr. Gregg C. Fonarow, a professor of cardiology at the University of California, Los Angeles, said he was surprised to find that the double dose wasn't beneficial overall and that it increased the risk of bleeding.

"A double dose of clopidogrel is an attractive option for patients with acute coronary syndrome undergoing coronary interventions compared with standard dosing," Fonarow said. "However, alternative antiplatelet agents, such as prasugrel (Effient) or ticagrelor (Brilinta), also have been proven to offer incremental benefits to standard dosing with clopidogrel."

The trial was funded by the pharmaceutical giants Sanofi-Aventis and Bristol-Myers Squibb, which make Plavix.

More information

For more information on heart disease, visit the American Heart Association.

SOURCES: Shamir Mehta, M.D., associate professor of cardiology, McMaster University, Hamilton, Ontario, Canada; Gregg Stone, M.D., director, cardiovascular research and education, Columbia University Medical Center, New York City; Gregg C. Fonarow, M.D., professor, cardiology, University of California, Los Angeles; Sept. 2, 2010, New England Journal of Medicine; Sept. 1, 2010, The Lancet, online


'/>"/>
Copyright©2010 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Plavix Can Help Cut Death Risk in Certain Heart Patients
2. Newer Blood Thinner Beats Plavix for Bypass Patients
3. Plavix Less Effective in Some Patients
4. Research demonstrates benefits of medical cannabis as a treatment for chronic pain
5. Researchers study benefits of white button mushrooms
6. Society of Interventional Radiology advances global definition of specialty, benefits patients
7. Social Security Disability Benefits Can Be Crucial to Surviving With Spinal Cord Injury, Allsup Reports
8. Advocate Health Care Reports $462 Million in Community Benefits
9. Intensively lowering glucose: Possible benefits must be weighed against risks
10. Examining risks and benefits of alcohol consumption
11. Experts analyze benefits, opportunities and challenges of Medicare Part D
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Double-Dose Plavix Benefits Certain Patients, Study Finds
(Date:2/21/2017)... ... ... Along with Valentine’s Day, February marks American Heart Month, a great time to ... lifetime of heart health. In addition, it is a time to prepare your ... Society of New Jersey (ATSNJ) is urging sports programs to prepare comprehensive guidelines for ...
(Date:2/20/2017)... Wis. (PRWEB) , ... February 21, 2017 , ... ... guidebook offering readers a way to “ Getting Over the Bump in the Road ... tips and lessons learned on how to cope with the ups and downs experienced ...
(Date:2/20/2017)... ... February 20, 2017 , ... Scrubbing in for his ... Houston, Dr. Christopher Pezzi remembers the excitement of the surgeon training him. , “He ... us to do this? Don’t tell anyone, but I would do it for free,’” ...
(Date:2/20/2017)... ... February 20, 2017 , ... ... a cloud-based self-service technology that runs on the Posiflex XT-series of touch screen ... during HIMSS17 in Orlando, Florida. The terminal provider Posiflex is helping ...
(Date:2/20/2017)... ... February 20, 2017 , ... ... you to stop by for a visit this week at HIMSS 2017 Conference ... executives from around the globe. Sensogram will be featured in the conference’s Connected ...
Breaking Medicine News(10 mins):
(Date:2/21/2017)... IBM ) Research has today announced new research developments ... retina. The Melbourne based IBM researchers ... in retina images, which could in the future offer doctors ... who may be at risk of eye diseases – such ... world. The research began in 2015 and ...
(Date:2/21/2017)... , Feb. 21, 2017 Diabetic Shoes Market: Overview ... ... be described as a disease, which is marked by high ... and insulin action. The disease has become a global epidemic ... Diabetes affects several organs of the body including eyes, kidneys, ...
(Date:2/21/2017)... -- /PR Newswire/ -- UBM Medica,s Eye Care Group ( ... Modern Retina ( www.modernretina.com ), a new ... Built upon the success of Ophthalmology Times , ... in the areas of retinal surgery, clinical information, research, ... informational needs and filling existing educational gaps, Modern ...
Breaking Medicine Technology: