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:6/24/2016)... ... 2016 , ... A recent article published June 14 on E ... goes on to state that individuals are now more comfortable seeking to undergo not ... as calf and cheek reduction. The Los Angeles area medical group, Beverly Hills Physicians ...
(Date:6/24/2016)... ... June 24, 2016 , ... Marcy was in a crisis. Her son James, eight, was ... his family verbally and physically. , “When something upset him, he couldn’t control his emotions,” ... He would throw rocks at my other children and say he was going to kill ...
(Date:6/24/2016)... ... June 24, 2016 , ... Dr. Amanda ... orthodontic treatment. Dr. Cheng has extensive experience with all areas of orthodontics, including ... accelerated osteogenic orthodontics. , Micro-osteoperforation is a revolutionary adjunct to orthodontic treatment. ...
(Date:6/24/2016)... Plano, TX (PRWEB) , ... June 24, 2016 , ... ... taking part in Genome magazine’s Code Talker Award, an essay contest in which patients ... for an award to be presented at the 2016 National Society of Genetic Counselors ...
(Date:6/24/2016)... ... June 24, 2016 , ... ... Grove Investment Group (TGIG), has initiated cultivation and processing operations at its production ... and Pahrump, Nevada. , Puradigm is the manufacturer of a complete system of ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... DUBLIN , June 23, 2016 ... the "Pharmaceutical Excipients Market by Type (Organic Chemical ... Preservative), Formulation (Oral, Topical, Coating, Parenteral) - Global Forecast ... The global pharmaceutical excipients ... 2021 at a CAGR of 6.1% in the forecast ...
(Date:6/23/2016)... 2016 Research and Markets has announced ... report to their offering. ... a favourable commercial environment for MedImmune to enter. The US ... will serve to drive considerable growth for effective anti-influenza medications. ... cap sales considerably, but development is still in its infancy. ...
(Date:6/23/2016)... -- Revolutionary technology includes multi-speaker listening to ... leaders in advanced audiology and hearing aid technology, has ... the world,s first internet connected hearing aid that opens ...      (Photo: http://photos.prnewswire.com/prnh/20160622/382240 ) , ... firsts,: , TwinLink™ - the first dual ...
Breaking Medicine Technology: