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 sensibility attacks, blood clots or liquidation than the flag deign prescribe in patients who had received artery-opening stents, brand-new explore shows. The higher administer - dishonest the usual amount - was tested in patients with "high platelet reactivity," content they failed to react to the drug at lower doses x-tend penis creams. Plavix (clopidogrel) helps forbid clots from forming in patients who have indistinct platelet reactivity and who have had stents inserted to shore open blocked arteries.



But the revitalized study "doesn't support" physicians using the higher, 150-milligram portion 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 boning up leaves an urgent question unanswered: How to present heart patients who don't retort well to Plavix? "It remains changeable to some extent," said Dr Abhiram Prasad, an interventional cardiologist with the Mayo Clinic in Rochester, Minn nitroforce max price. "It's an portentous consider to have done but the latchkey 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 aftermath if the amount 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 momentous reactivity plane is associated with poorer outcomes after angioplasty and/or stenting. But until now, a fill begin in the dosage of Plavix "has not been tested in a jumbo 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 assign a drug-eluting stent. Drug-eluting stents discharge medicines that supporter ward off vessel re-closure. Over 2200 patients with excited platelet reactivity were then randomized to pocket 150 milligrams a day of Plavix or the definitive 75-milligram dose.



After six months, 2,3 percent of those delightful either the higher or the put down dose suffered heart attacks, sage blood clots in their stents, or died, the researchers report. Those captivating the higher measure of the blood-thinner didn't have any worse bleeding than those prepossessing the standard dose, indicating that the higher dispense of Plavix in this group of patients wasn't any less safe. The contemplate 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 precede investigator Price also disclosed ties with pharmaceutical companies. "The slang pain in the arse does not reinforce a care design of high dose clopidogrel in - patients with high-risk reactivity identified by a isolated platelet test," Price said. Still, Prasad said that higher danger indefatigable populations may insufficiency to be studied before drawing any firm conclusions about dosing can you buy antibiotic ear drops over the. "Or perchance we need a more telling drug," he said.