Navigation Links
Matrix registry probes adherence to clopidogrel at 1 year
Date:3/31/2008

CHICAGO, Ill. (March 31, 2008) A large community-based registry of patients treated with drug-eluting stents is providing important insight into how long patients with complex coronary artery disease typically stick to their doctors orders to take clopidogrel, a drug that prevents unwanted blood clots; why they stop taking the drug; and the long-term consequences of that decision.

The new data from the MATRIX Registry, a large proportion of which represents off-label use of sirolimus-eluting stents, will be reported 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).

Long-term clopidogrel therapy appears to be a critical factor in avoiding late stent thrombosis, an uncommon but serious complication that occurs when a blood clot blocks the stent. Such clots can form a year or more after stenting and can cause a heart attack or even death.

The MATRIX Registry is particularly valuable because it provides a real-world view of a wide variety of patients, many of whom do not fit the strict profiles used in clinical trials leading to device approval by the Food and Drug Administration. Treatment of such patients with drug-eluting stents is considered off-label, but is both common in clinical practice and legal.

George Dangas, MD, PhD, an associate professor of medicine at Columbia University Medical Center and program director of interventional cardiology at New York-Presbyterian Hospital, New York City, led the new analysis of the MATRIX Registry data. A total of 1,510 patients were included in the study. They had a very different profile from patients enrolled in early clinical trials. Some 33.3 percent had previously had a heart attack, 44.4 percent had had a prior coronary intervention, 21 percent had had bypass surgery, 33.7 percent had diabetes and 27.7 percent had unstable angina.

All patients received aspirin, clopidogrel and other anti-clotting drugs during stenting. After stenting, all were prescribed aspirin 325 mg daily for one month and 81 mg indefinitely thereafter, plus clopidogrel 75 mg daily for one year, with subsequent clopidogrel prescription left up to physician discretion.

The researchers found that by six months, 10 percent of patients who were available for follow-up (133 out of 1,324) were no longer taking clopidogrel as prescribed. By one year, that number had edged up to 17.4 percent (233 out of 1,338) and by two years, to 33.2 percent (291 out of 877). However, of patients who were no longer taking clopidogrel at six months, nearly half were back on the medication at one- or two-year follow-up.

At one year, discontinuation of clopidogrel was attributed to doctors choice in 9.9 percent of patients, bleeding in 5.2 percent, surgery in 2.1 percent, rash or allergy in 1.7 percent and cost in 0.4 percent. In 39.5 percent of patients, the reason for discontinuation was unknown; 41.2 percent of patients discontinued clopidogrel simply because the recommended one-year dosing period had come to an end.

Researchers also evaluated clinical outcomes at various time points, dividing patients into those who continued taking clopidogrel and those who stopped. Patients who stopped taking clopidogrel by one year had a significantly higher risk of death when compared to those who continued taking the medication (4.8 percent vs. 1.4 percent, respectively, p=0.005); however, there was no significant difference in rates of cardiac death (1.1 percent vs. 0.2 percent, p=0.054), noncardiac death (2.7 percent vs. 1.0 percent, p=0.08) and unknown death (1.0 percent vs. 0.3 percent, p=0.16). The need for a repeat procedure to re-treat the target lesion or to reopen the target coronary artery was lower in patients who stopped taking clopidogrel (0 percent vs. 5.5 percent, p=0.001, and 0.5 percent vs. 6.1 percent, p=0.002, respectively).

Rates of stent thrombosis in the MATRIX Registry were 0.9 percent at two yearsvery low, particularly given that 86 percent of patients were treated for an off-label indication. Investigators attributed the low thrombosis rate to the highly experienced interventional cardiologists who performed stent implantation and the use of intravascular ultrasound to ensure precise stent placement in 35 percent of patients.

Dr. Dangas will present the new data from the MATRIX Registry on Monday, March 31 at 8:30 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. Matrixx Initiatives, Inc. to Present at the Roth Capital Partners 2007 New York Conference
2. Matrixx Initiatives, Inc. to Present at the William Blair & Company Small-Cap Growth Stock Conference
3. Collagen Matrix, Inc. Receives FDA 510(k) Clearance for SynOss(TM) Synthetic Mineral Bone Graft Material
4. Matrixx Initiatives, Inc. Updates 2007/2008 Cold Season Trends and Fiscal 2008 Sales and Earnings Outlook
5. Matrixx Initiatives, Inc. Sets Time for Discussion of Third Quarter Fiscal 2008 Financial Results
6. Matrixx Initiatives, Inc. Reports Fiscal 3rd Quarter Net Sales of $30.8 Million and Net Loss of ($0.07) Per Share
7. Matrixx Initiatives, Inc. to Present at the Roth Capital Partners 20th Annual OC Growth Stock Conference
8. Mylan Confirms Its Matrix Design Fentanyl Patch Is Not Included In the Widespread Recall Announced February 12th
9. Mylan Announces Appointment of Jagdish Dore as CEO and Managing Director of Matrix Laboratories
10. Rising Medical Solutions Partners With myMatrixx to Deliver Integrated Pharmacy Management Solutions
11. Data from Patient Subsets of e-HEALING, a Worldwide Registry, Support Use of OrbusNeichs Genous(TM) Bio-Engineered R Stent(TM) as Alternative to Drug- Eluting Stents
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/26/2016)... ... ... Quality metrics are proliferating in cancer care, and are derived from many ... the beholder, according to experts who offered insights and commentary in the current issue ... the full issue, click here . , For the American Society of Clinical ...
(Date:6/26/2016)... ... June 26, 2016 , ... Brent Kasmer, a legally blind and certified personal trainer ... through a fitness app. The fitness app plans to fix the two major problems leading ... a one size fits all type program , They don’t eliminate all the ...
(Date:6/25/2016)... ... ... of Bruton Memorial Library on June 21 due to a possible lice infestation, as reported ... head lice: the parasite’s ability to live away from a human host, and to infest ... in the event that lice have simply gotten out of control. , As lice are ...
(Date:6/25/2016)... , ... June 25, 2016 , ... ... and non-athletes recover from injury. Recently, he has implemented orthobiologic procedures as a ... area —Johnson is one of the first doctors to perform the treatment. Orthobiologics ...
(Date:6/24/2016)... ... 24, 2016 , ... Those who have experienced traumatic events may suffer from ... avenues, such as drug or alcohol abuse, as a coping mechanism. To avoid this ... coping following a traumatic event. , Trauma sufferers tend to feel a range of ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... -- Any dentist who has made an implant supported denture ... of them do not even offer this as a viable ... costs involved. And those who ARE able to offer that ... cost that the majority of today,s patients would not be ... , founder of Dental Evolutions Inc. and inventor of Implanova ...
(Date:6/23/2016)... Roche (SIX: RO, ROG; OTCQX: RHHBY) announced that it ... (procalcitonin) assay as a dedicated testing solution for people ... Roche is the first IVD company in the U.S ... assessment and management. PCT is a sepsis-specific ... blood can aid clinicians in assessing the risk of ...
(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. ...
Breaking Medicine Technology: