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Tests to Measure Safety of Anti-Clotting Drugs of Limited Value
Date:2/23/2010

on, Bhatt said. "It sets us up for the next step. You have a patient at moderate risk; what do you do with that test information? That is a question that needs to be answered."

Several large studies are underway to provide an answer, Bhatt said. They are looking at large numbers of people who get clot-preventing drugs. "Right now, you can conclude that some tests are correlated with an increased risk of adverse events, but what to do with that information is unclear," Bhatt said. "Those ongoing trials may provide an answer."

Trail results will not be available for "a minimum of one to two years," he noted. "My feeling is that until then, there is not enough data to test routinely."

While the Dutch study provided "an important observation," it included a relatively narrow portion of people eligible for clot-dissolving drug therapy, added Dr. Magnus Ohman, director of the Program for Advanced Coronary Disease at Duke University in Durham, N.C.

"This tested patients after stenting, a relatively isolated group of patients," Ohman said. "All patients who are treated medically with clot-preventing medication tend to be older, have more bleeding, have more problems with metabolism. The study fails to give an overall picture of how high-risk patients fare."

Even though the study population was relatively large, it is small in relation to the total population of people who get clot-preventing drugs, Ohman said. "If we studied more patients and higher-risk patients, we might get a better handle on this. We might find other cutoff points of greater value."

Some of the tests "clearly give information we doctors need," Ohman said. Right now, Duke cardiologists use only the most complex test in the study, light transmittance aggregometry, which requires sophisticated laboratory equipment and takes hours for results, he said.

"We are in the process of evaluating the bedside tests because they will have an import
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