Navigation Links
Higher Plavix Dose Won't Boost Outcomes After Stent Placement: Study
Date:11/17/2010

By Amanda Gardner
HealthDay Reporter

TUESDAY, Nov. 16 (HealthDay News) -- Higher doses of the blood-thinner Plavix were no better at preventing heart attacks, blood clots or death than the standard lower dose in patients who had received artery-opening stents, new research shows.

The higher dose -- double the usual amount -- was tested in patients with "high platelet reactivity," meaning they failed to respond to the drug at lower doses.

Plavix (clopidogrel) helps prevent clots from forming in patients who have low platelet reactivity and who have had stents inserted to prop open blocked arteries.

But the new study "doesn't support" physicians using the higher, 150-milligram dose of Plavix after stenting, according to study lead author Dr. Matthew Price, who presented the findings Tuesday at the annual meeting of the American Heart Association in Chicago.

So, the study leaves an important question unanswered: How to treat heart patients who don't respond well to Plavix?

"It remains uncertain to some extent," said Dr. Abhiram Prasad, an interventional cardiologist with the Mayo Clinic in Rochester, Minn. "It's an important study to have done but the key issues are that a significant proportion of the patients remained with high platelet reactivity even after being on the higher dose."

Previous, smaller studies had indicated that Plavix might have more of an effect if the dose was doubled.

"Platelet reactivity varies widely," noted Price, director of the Cardiac Catheterization Laboratory at the Scripps Clinic in La Jolla, Calif. He explained that numerous studies have shown that a high reactivity level is associated with poorer outcomes after angioplasty and/or stenting. But until now, a steep rise in the dose of Plavix "has not been tested in a large randomized clinical trial," he said.

For this trial, investigators tested a large group of patients for platelet reactivity after they had undergone angioplasty to place a drug-eluting stent. Drug-eluting stents emit medicines that help ward off vessel re-closure.

Over 2,200 patients with high platelet reactivity were then randomized to receive 150 milligrams a day of Plavix or the standard 75-milligram dose.

After six months, 2.3 percent of those taking either the higher or the lower dose suffered heart attacks, experienced blood clots in their stents, or died, the researchers report.

Those taking the higher dose of the blood-thinner didn't have any worse bleeding than those taking the standard dose, indicating that the higher dose of Plavix in this group of patients wasn't any less safe.

The study was sponsored by Accumetrics, which makes VerifyNow, a test used to measure platelet function. The makers of Plavix, Sanofi-Aventis and Bristol-Myers Squibb provided the drug, and lead investigator Price also disclosed ties with pharmaceutical companies.

"The trial does not support a treatment strategy of high dose clopidogrel in . . . patients with high-risk reactivity identified by a single platelet test," Price said.

Still, Prasad said that higher risk patient populations may need to be studied before drawing any firm conclusions about dosing. "Or maybe we need a more potent drug," he said.

More information

For more on stents, visit the U.S. National Heart, Lung, and Blood Institute.

SOURCES: Abhiram Prasad, M.D., interventional cardiologist, Mayo Clinic, Rochester, Minn.; American Heart Association annual meeting news conference with Matthew J. Price, M.D., director, Cardiac Catheterization Laboratory, Scripps Clinic and assistant professor, Scripps Translational Science Institute, La Jolla, Calif., Nov. 16, 2010


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

Related medicine news :

1. Prostate cancer treatment linked to higher rate of colon cancer, study finds
2. Higher Statin Doses Linked to Fewer Heart Attacks, Stroke
3. Higher medication spending doesnt indicate better prescribing quality
4. Many Higher-Income Parents Forgoing Kids Vaccinations: Report
5. Organic onions, carrots and potatoes do not have higher levels of healthful antioxidants
6. Concussion Rate in Young Hockey Players Higher Than Thought
7. Shift work linked to higher risk of work injury: UBC study
8. Elderly women at higher risk for unnecessary urinary catheterization, study reports
9. Children with ADHD Symptoms at Higher Risk of Obesity
10. Brain Deficits Higher in Seniors Who Survive Blood Poisoning
11. GI Endoscopy Complication Rates Higher Than Suspected: Study
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Higher Plavix Dose Won't Boost Outcomes After Stent Placement: Study
(Date:6/25/2016)... Viejo, California (PRWEB) , ... June 25, 2016 , ... ... to fit their specific project," said Christina Austin - CEO of Pixel Film Studios. ... fully customizable and all within Final Cut Pro X . Simply select a ...
(Date:6/25/2016)... ... June 25, 2016 , ... On Friday, June 10, Van Mitchell, Secretary ... Work award to iHire in recognition of their exemplary accomplishments in worksite health promotion. ... Maryland Workplace Health & Wellness Symposium at the BWI Marriott in Linthicum Heights. iHire ...
(Date:6/24/2016)... ... ... June 19, 2016 is World Sickle Cell Observance Day. In an effort ... holistic treatments, Serenity Recovery Center of Marne, Michigan, has issued a pain ... Disease (SCD) is a disorder of the red blood cells, which can cause episodes ...
(Date:6/24/2016)... ... 24, 2016 , ... Dr. Amanda Cheng, an orthodontist ... has extensive experience with all areas of orthodontics, including robotic Suresmile technology, ... , Micro-osteoperforation is a revolutionary adjunct to orthodontic treatment. It can be used ...
(Date:6/24/2016)... ... June 24, 2016 , ... ... Clinical Decision Making in Emergency Medicine conference in Ponte Vedra Beach, FL. The ... published in Emergency Medicine Practice and Pediatric Emergency Medicine Practice. , ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... ITASCA, Ill. , June 23, 2016  In a startling ... states are failing their residents by lacking a comprehensive, proven plan ... , a definitive ranking of how states are tackling the ... rating to only four states – Kentucky , ... and Vermont . Of the 28 failing states, ...
(Date:6/23/2016)... June 23, 2016 Bracket , a leading ... next generation clinical outcomes platform, Bracket eCOA (SM) 6.0, ... June 26 – 30, 2016 in Philadelphia ... Clinical Outcome Assessment product of its kind to fully integrate ... Bracket eCOA 6.0 is a flexible platform for electronic ...
(Date:6/23/2016)... -- Guerbet announced today that it has been named a ... One of 12 suppliers to receive the ... of Premier members through exceptional local customer service and ... lower costs. "We ... customer service from Premier," says Massimo Carrara , ...
Breaking Medicine Technology: