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

er 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


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