The Problem Of Treating Patients With Heart Disease Who Do Not Respond To Plavix

The Problem Of Treating Patients With Heart Disease Who Do Not Respond To Plavix.
Higher doses of the blood-thinner Plavix were no better at preventing sincerity attacks, blood clots or eradication than the touchstone diminish dosage in patients who had received artery-opening stents, new analyse shows. The higher dose - dishonest the usual amount - was tested in patients with "high platelet reactivity," connotation they failed to respond to the drug at lower doses bladder torture. Plavix (clopidogrel) helps enjoin clots from forming in patients who have short platelet reactivity and who have had stents inserted to prop out blocked arteries.

But the new study "doesn't support" physicians using the higher, 150-milligram dispense of Plavix after stenting, according to scan lead author Dr Matthew Price, who presented the findings Tuesday at the annual tryst of the American Heart Association in Chicago. So, the inquiry leaves an important question unanswered: How to manage heart patients who don't respond well to Plavix? "It remains dubious to some extent," said Dr Abhiram Prasad, an interventional cardiologist with the Mayo Clinic in Rochester, Minn. "It's an signal chew over to have done but the key issues are that a significant modify 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 impact if the measure was doubled. "Platelet reactivity varies widely," noted Price, commandant of the Cardiac Catheterization Laboratory at the Scripps Clinic in La Jolla, Calif. He explained that numerous studies have shown that a grave reactivity smooth is associated with poorer outcomes after angioplasty and/or stenting. But until now, a abrupt rise in the administer of Plavix "has not been tested in a large randomized clinical trial".

For this trial, investigators tested a humongous group of patients for platelet reactivity after they had undergone angioplasty to situate a drug-eluting stent. Drug-eluting stents eject medicines that help section off vessel re-closure. Over 2200 patients with high platelet reactivity were then randomized to admit 150 milligrams a day of Plavix or the paragon 75-milligram dose.

After six months, 2,3 percent of those taking either the higher or the farther down dose suffered heart attacks, professional blood clots in their stents, or died, the researchers report. Those taking the higher amount of the blood-thinner didn't have any worse bleeding than those taking the support dose, indicating that the higher dose of Plavix in this gang of patients wasn't any less safe. The study was sponsored by Accumetrics, which makes VerifyNow, a investigation used to appraise platelet function.

The makers of Plavix, Sanofi-Aventis and Bristol-Myers Squibb provided the drug, and manage investigator Price also disclosed ties with pharmaceutical companies. "The bother does not support a care strategy of high dose clopidogrel in - patients with high-risk reactivity identified by a one platelet test". Still, Prasad said that higher chance patient populations may shortage to be studied before drawing any firm conclusions about dosing reviews. "Or perchance we need a more potent drug".