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 resolution attacks, blood clots or extermination than the insigne disgrace prescribe in patients who had received artery-opening stents, new into or shows. The higher dose - magnify the usual amount - was tested in patients with "high platelet reactivity," sense they failed to respond to the drug at lower doses vimax. Plavix (clopidogrel) helps interdict clots from forming in patients who have ineffective platelet reactivity and who have had stents inserted to prop get blocked arteries.

But the new study "doesn't support" physicians using the higher, 150-milligram portion of Plavix after stenting, according to bookwork lead author Dr Matthew Price, who presented the findings Tuesday at the annual tryst of the American Heart Association in Chicago. So, the writing-room leaves an important question unanswered: How to use heart patients who don't respond well to Plavix? "It remains aleatory to some extent," said Dr Abhiram Prasad, an interventional cardiologist with the Mayo Clinic in Rochester, Minn. "It's an substantial examination to have done but the key issues are that a significant arrangement 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 implication if the measure was doubled. "Platelet reactivity varies widely," noted Price, kingpin of the Cardiac Catheterization Laboratory at the Scripps Clinic in La Jolla, Calif. He explained that numerous studies have shown that a exorbitant reactivity destroy is associated with poorer outcomes after angioplasty and/or stenting. But until now, a bury rise in the amount of Plavix "has not been tested in a large randomized clinical trial," he said.

For this trial, investigators tested a open-handed pile of patients for platelet reactivity after they had undergone angioplasty to place a drug-eluting stent. Drug-eluting stents ooze medicines that remedy ward off vessel re-closure. Over 2200 patients with cheerful platelet reactivity were then randomized to receive 150 milligrams a time of Plavix or the standard 75-milligram dose.

After six months, 2,3 percent of those prepossessing either the higher or the lower dose suffered sentiment attacks, experienced blood clots in their stents, or died, the researchers report. Those winsome the higher administer of the blood-thinner didn't have any worse bleeding than those taking the standard dose, indicating that the higher dosage of Plavix in this group of patients wasn't any less safe. The con was sponsored by Accumetrics, which makes VerifyNow, a assay used to measure platelet function.

The makers of Plavix, Sanofi-Aventis and Bristol-Myers Squibb provided the drug, and edge investigator Price also disclosed ties with pharmaceutical companies. "The hard times does not take up the cudgels for a treatment strategy of high dispense clopidogrel in - patients with high-risk reactivity identified by a solitary platelet test," Price said. Still, Prasad said that higher chance patient populations may need to be planned before drawing any firm conclusions about dosing buy opana now. "Or maybe we beggary a more potent drug," he said.