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 affection attacks, blood clots or eradication than the footing humble dispense in patients who had received artery-opening stents, new inspection shows. The higher dose - duplicate the usual amount - was tested in patients with "high platelet reactivity," signification they failed to respond to the drug at lower doses proextender.gdn. Plavix (clopidogrel) helps forbid clots from forming in patients who have bawl platelet reactivity and who have had stents inserted to prop liable blocked arteries.
But the new study "doesn't support" physicians using the higher, 150-milligram dosage of Plavix after stenting, according to over lead author Dr Matthew Price, who presented the findings Tuesday at the annual junction of the American Heart Association in Chicago. So, the boning up leaves an important question unanswered: How to boon heart patients who don't respond well to Plavix? "It remains changeable to some extent," said Dr Abhiram Prasad, an interventional cardiologist with the Mayo Clinic in Rochester, Minn effects. "It's an respected learn to have done but the key issues are that a significant part of the patients remained with high platelet reactivity even after being on the higher dose".
Previous, smaller studies had indicated that Plavix might have more of an cause if the portion was doubled. "Platelet reactivity varies widely," noted Price, steersman of the Cardiac Catheterization Laboratory at the Scripps Clinic in La Jolla, Calif. He explained that numerous studies have shown that a exorbitant reactivity height is associated with poorer outcomes after angioplasty and/or stenting manual de uso pro extender en nottingham. But until now, a high rise in the administer of Plavix "has not been tested in a large randomized clinical trial".
For this trial, investigators tested a hefty group of patients for platelet reactivity after they had undergone angioplasty to estate a drug-eluting stent. Drug-eluting stents out medicines that help division off vessel re-closure. Over 2200 patients with high platelet reactivity were then randomized to suffer 150 milligrams a day of Plavix or the emblem 75-milligram dose.
After six months, 2,3 percent of those taking either the higher or the quieten dose suffered heart attacks, au fait blood clots in their stents, or died, the researchers report. Those taking the higher amount of the blood-thinner didn't have any worse bleeding than those taking the criterion dose, indicating that the higher dose of Plavix in this catalogue of patients wasn't any less safe. The study was sponsored by Accumetrics, which makes VerifyNow, a check used to spread platelet function.
The makers of Plavix, Sanofi-Aventis and Bristol-Myers Squibb provided the drug, and edge investigator Price also disclosed ties with pharmaceutical companies. "The nuisance does not support a healing strategy of high dose clopidogrel in - patients with high-risk reactivity identified by a free platelet test". Still, Prasad said that higher jeopardize patient populations may exigency to be studied before drawing any firm conclusions about dosing ague forte. "Or c peradventure we need a more potent drug".
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