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 empathy attacks, blood clots or passing than the recognized lower dose in patients who had received artery-opening stents, late research shows. The higher dose - double-barrelled the usual amount - was tested in patients with "high platelet reactivity," meaning they failed to counter to the drug at lower doses. Plavix (clopidogrel) helps prevent clots from forming in patients who have gloomy platelet reactivity and who have had stents inserted to prop open blocked arteries.

But the further study "doesn't support" physicians using the higher, 150-milligram dose of Plavix after stenting, according to enquiry lead author Dr Matthew Price, who presented the findings Tuesday at the annual encounter of the American Heart Association in Chicago. So, the study leaves an important question unanswered: How to entertain heart patients who don't respond well to Plavix? "It remains variable to some extent," said Dr Abhiram Prasad, an interventional cardiologist with the Mayo Clinic in Rochester, Minn. "It's an conspicuous study to have done but the key issues are that a significant proportion of the patients remained with serious platelet reactivity even after being on the higher dose".

Previous, smaller studies had indicated that Plavix might have more of an effect if the amount was doubled. "Platelet reactivity varies widely," noted Price, director of the Cardiac Catheterization Laboratory at the Scripps Clinic in La Jolla, Calif. He explained that numerous studies have shown that a squiffy reactivity plane is associated with poorer outcomes after angioplasty and/or stenting. But until now, a sharp rise in the dose of Plavix "has not been tested in a large randomized clinical trial".

For this trial, investigators tested a ginormous group of patients for platelet reactivity after they had undergone angioplasty to chore a drug-eluting stent. Drug-eluting stents emit medicines that help quarter off vessel re-closure. Over 2200 patients with high platelet reactivity were then randomized to gross 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 modulate dose suffered heart attacks, experienced blood clots in their stents, or died, the researchers report. Those taking the higher dispense of the blood-thinner didn't have any worse bleeding than those taking the criterion dose, indicating that the higher dose of Plavix in this group of patients wasn't any less safe. The learning was sponsored by Accumetrics, which makes VerifyNow, a test used to moderation platelet function.

The makers of Plavix, Sanofi-Aventis and Bristol-Myers Squibb provided the drug, and vanguard investigator Price also disclosed ties with pharmaceutical companies. "The trial does not support a curing strategy of high dose clopidogrel in - patients with high-risk reactivity identified by a lone platelet test". Still, Prasad said that higher risk patient populations may dearth to be studied before drawing any firm conclusions about dosing garcinia cambogia scriptovore. "Or maybe we need a more potent drug".