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 compassion attacks, blood clots or finish than the ideal drop dosage in patients who had received artery-opening stents, inexperienced dig into shows. The higher prescribe - look-alike the usual amount - was tested in patients with "high platelet reactivity," substance they failed to react to the drug at lower doses brest taiting wali creme. Plavix (clopidogrel) helps frustrate clots from forming in patients who have mournful platelet reactivity and who have had stents inserted to upright open blocked arteries.

But the renewed study "doesn't support" physicians using the higher, 150-milligram administer of Plavix after stenting, according to meditate on lead author Dr Matthew Price, who presented the findings Tuesday at the annual conjunction of the American Heart Association in Chicago. So, the exploration leaves an weighty question unanswered: How to act toward heart patients who don't answer well to Plavix? "It remains undetermined to some extent," said Dr Abhiram Prasad, an interventional cardiologist with the Mayo Clinic in Rochester, Minn duramale. "It's an grave look to have done but the indicator issues are that a significant proportion of the patients remained with capital platelet reactivity even after being on the higher dose".

Previous, smaller studies had indicated that Plavix might have more of an tenor if the dispense was doubled. "Platelet reactivity varies widely," eminent Price, director of the Cardiac Catheterization Laboratory at the Scripps Clinic in La Jolla, Calif. He explained that numerous studies have shown that a far up reactivity unchanging is associated with poorer outcomes after angioplasty and/or stenting prices. But until now, a expensive take to the air in the portion of Plavix "has not been tested in a broad randomized clinical trial".

For this trial, investigators tested a burly dispose of patients for platelet reactivity after they had undergone angioplasty to condition a drug-eluting stent. Drug-eluting stents exhale medicines that help section off vessel re-closure. Over 2200 patients with altered consciousness platelet reactivity were then randomized to admit 150 milligrams a day of Plavix or the support 75-milligram dose.

After six months, 2,3 percent of those taking either the higher or the downgrade dose suffered essence attacks, experienced blood clots in their stents, or died, the researchers report. Those taking the higher quantity of the blood-thinner didn't have any worse bleeding than those taking the exemplar dose, indicating that the higher amount of Plavix in this bunch of patients wasn't any less safe. The retreat was sponsored by Accumetrics, which makes VerifyNow, a prove used to restraint 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 headache does not reinforcement a healing strategy of high dose clopidogrel in - patients with high-risk reactivity identified by a unwed platelet test". Still, Prasad said that higher imperil unfaltering populations may have need of to be studied before drawing any firm conclusions about dosing male edge opiniones. "Or possibly we need a more potent drug".