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 enthusiasm attacks, blood clots or liquidation than the prevailing quieten quantity in patients who had received artery-opening stents, further scrutinization shows. The higher amount - traitorous the usual amount - was tested in patients with "high platelet reactivity," substance they failed to reciprocate to the drug at lower doses buy amyl nitrate bangkok. Plavix (clopidogrel) helps preclude clots from forming in patients who have weak platelet reactivity and who have had stents inserted to buttress open blocked arteries.



But the imaginative study "doesn't support" physicians using the higher, 150-milligram dispense of Plavix after stenting, according to look at lead author Dr Matthew Price, who presented the findings Tuesday at the annual conjunction of the American Heart Association in Chicago. So, the consider leaves an momentous question unanswered: How to analyse heart patients who don't reply well to Plavix? "It remains hesitating to some extent," said Dr Abhiram Prasad, an interventional cardiologist with the Mayo Clinic in Rochester, Minn. "It's an foremost scan to have done but the translation issues are that a significant proportion of the patients remained with altered consciousness platelet reactivity even after being on the higher dose".



Previous, smaller studies had indicated that Plavix might have more of an essence if the administer was doubled. "Platelet reactivity varies widely," celebrated Price, director of the Cardiac Catheterization Laboratory at the Scripps Clinic in La Jolla, Calif. He explained that numerous studies have shown that a favourable reactivity up to date is associated with poorer outcomes after angioplasty and/or stenting. But until now, a immerse be created in the prescribe of Plavix "has not been tested in a mammoth randomized clinical trial," he said.



For this trial, investigators tested a great collection of patients for platelet reactivity after they had undergone angioplasty to lieu a drug-eluting stent. Drug-eluting stents issue medicines that aide ward off vessel re-closure. Over 2200 patients with exalted platelet reactivity were then randomized to bear 150 milligrams a day of Plavix or the usual 75-milligram dose.



After six months, 2,3 percent of those fascinating either the higher or the bring dose suffered heart attacks, savvy blood clots in their stents, or died, the researchers report. Those compelling the higher portion of the blood-thinner didn't have any worse bleeding than those attractive the standard dose, indicating that the higher measure of Plavix in this group of patients wasn't any less safe. The library was sponsored by Accumetrics, which makes VerifyNow, a examination used to measure platelet function.



The makers of Plavix, Sanofi-Aventis and Bristol-Myers Squibb provided the drug, and prima donna investigator Price also disclosed ties with pharmaceutical companies. "The examination does not succour a healing procedure of high dose clopidogrel in - patients with high-risk reactivity identified by a unique platelet test," Price said. Still, Prasad said that higher jeopardy tolerant populations may essential to be studied before drawing any firm conclusions about dosing rxlistbox.com. "Or perhaps we need a more strong drug," he said.