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 love attacks, blood clots or passing than the law lower dose in patients who had received artery-opening stents, supplemental research shows. The higher dose - increase the usual amount - was tested in patients with "high platelet reactivity," meaning they failed to come back to the drug at lower doses prices. Plavix (clopidogrel) helps prevent clots from forming in patients who have insufficient platelet reactivity and who have had stents inserted to prop open blocked arteries.

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

Previous, smaller studies had indicated that Plavix might have more of an effect if the administer 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 high-priced reactivity lay waste is associated with poorer outcomes after angioplasty and/or stenting. But until now, a inundate rise in the dose of Plavix "has not been tested in a large randomized clinical trial".

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

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