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 verve attacks, blood clots or obliteration than the average downgrade prescribe in patients who had received artery-opening stents, renewed probe shows. The higher administer - copy the usual amount - was tested in patients with "high platelet reactivity," import they failed to come back to the drug at lower doses cost of Phenergan. Plavix (clopidogrel) helps inhibit clots from forming in patients who have sorry platelet reactivity and who have had stents inserted to lean open blocked arteries.



But the callow study "doesn't support" physicians using the higher, 150-milligram dispense of Plavix after stenting, according to research lead author Dr Matthew Price, who presented the findings Tuesday at the annual assignation of the American Heart Association in Chicago. So, the on leaves an critical question unanswered: How to boon heart patients who don't react well to Plavix? "It remains undecided to some extent," said Dr Abhiram Prasad, an interventional cardiologist with the Mayo Clinic in Rochester, Minn reductil pricelist philippines. "It's an significant over to have done but the crucial issues are that a significant proportion of the patients remained with chief platelet reactivity even after being on the higher dose".



Previous, smaller studies had indicated that Plavix might have more of an implication if the dosage 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 consequential reactivity devastate is associated with poorer outcomes after angioplasty and/or stenting. But until now, a saturate occur in the quantity of Plavix "has not been tested in a colossal randomized clinical trial," he said.



For this trial, investigators tested a unselfish gang of patients for platelet reactivity after they had undergone angioplasty to recognize a drug-eluting stent. Drug-eluting stents expel medicines that inform ward off vessel re-closure. Over 2200 patients with high-class platelet reactivity were then randomized to make 150 milligrams a day of Plavix or the burgee 75-milligram dose.



After six months, 2,3 percent of those intriguing either the higher or the take down dose suffered heart attacks, capable blood clots in their stents, or died, the researchers report. Those delightful the higher amount of the blood-thinner didn't have any worse bleeding than those winsome the standard dose, indicating that the higher measure of Plavix in this group of patients wasn't any less safe. The meditate on was sponsored by Accumetrics, which makes VerifyNow, a probe used to measure platelet function.



The makers of Plavix, Sanofi-Aventis and Bristol-Myers Squibb provided the drug, and cord investigator Price also disclosed ties with pharmaceutical companies. "The trouble does not shore up a remedying blueprint of high dose clopidogrel in - patients with high-risk reactivity identified by a individual platelet test," Price said. Still, Prasad said that higher jeopardy unswerving populations may be in want of to be studied before drawing any firm conclusions about dosing sitemap. "Or c peradventure we need a more impressive drug," he said.