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Doubling Plavix Dose Recommended Before Angioplasty

Never mind the side-effects of Plavix, (generic name clopidogrel), the popular anti-blood-clotting drug .

A new study reveals doubling the current recommended dose of Plavix to angioplasty patients, from 300 milligrams to 600, cut the combined risk of heart attack and cardiac death by half.

Dr. Anthony Abbate, an assistant professor of medicine at Virginia Commonwealth University says the higher dose did not increase the risk of serious bleeding, a major concern with Plavix.

Abbate and Dr. Giuseppe G. Biondi-Zoccai, an assistant professor of cardiology at the University of Turin in Italy had analyzed ten previous studies and covered 1,500 patients who had angioplasty. Most had either 300 milligrams or 600 milligrams of Plavix before the procedure.

"The evidence is very powerful," said Dr. Gregory Dehmer, president of the society and a professor of medicine at Texas A&M College of Medicine. "Although Plavix is powerful stuff, the meta-analysis did not find an excessive amount of bleeding. So we have a lower risk of myocardial infarction [heart attack] with no significant increase in adverse side effects."

The incidence of cardiac death or non-fatal heart attack was 50 percent lower in the following 30 days in those getting the higher dose of Plavix. Only 3.1 percent of those getting the 600-milligram dose had in-hospital heart attacks, compared to 6.4 percent of those getting the 300-milligram dose. The overall 30-day incidence of death or heart attack was 3.8 percent for the higher dose and 7.3 percent for the lower dose, according to the study.

"This research has important clinical and cost implications," Biondi-Zoccai said in a prepared statement.

Current guidelines by the American Heart Association, the American College of Cardiology and the Society for Cardiovascular Angiography and Interventions say that physicians should "strongly consider" giving 300 milligrams o
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