2nd Drug After Heart Attacks Can Help Patients, 2 Studies Find

By THE ASSOCIATED PRESS

Published: March 10, 2005

ORLANDO, Fla., March 9 (AP) - Adding Plavix to other anticlotting drugs typically given to heart attack patients saves lives and prevents second heart attacks, two international studies have found.

The strategy, specialists said, is the first big advance in care after heart attacks in more than 10 years, since the efficacy of modern clot-busters was shown. The low-cost and simple treatment of using Plavix will have major effects in community hospitals, where most Americans obtain care, the scientists said.

It could also help in poorer countries, where heart surgery and the opening of blocked arteries are not common.

Two weeks of Plavix pills cost $50 to $100 a patient.

"It really is a great day for heart attack patients," a researcher, Dr. Christopher P. Cannon of the Harvard Medical School, said.

Plavix is used to prevent clotting. Its safety and effectiveness in treating major heart attacks had not been tested. The two studies were paid for by the sellers of Plavix, Sanofi-Aventis and Bristol-Myers Squibb. Many of the researchers have consulted for the two companies.

The results of the studies were presented here at a conference of the American College of Cardiology. One study was published online by The New England Journal of Medicine and will be in its March 24 print edition.

The studies looked at heart attacks caused by large clots that fully or almost completely blocked major arteries, the type that account for about a third of the 865,000 heart attacks each year in the United States and the 10 million worldwide.

Those patients can be treated with emergency procedures to open arteries or with medications to dissolve clots until the patients can have an angiogram to determine the need for surgery or angioplasty. Arteries reclose about one-fourth of the time in medicated people, doubling their risk of dying before a procedure.

One study, with 46,000 Chinese, found that the risk of death, stroke or another heart attack was 9 percent lower in patients given Plavix along with standard anticlotting drugs like aspirin, heparin and the clot breakers TPA or streptokinase than in patients given just the standard drugs. The risks of bleeding and other serious side effects were no different.

The other study was led by Dr. Marc S. Sabatine of Harvard and the Brigham and Women's Hospital in Boston and involved 3,491 heart attack patients in Europe given standard drugs with or without Plavix.

The risk of death, another heart attack or artery reclogging was 21.7 percent in patients taking just standard drugs and 15 percent among those given Plavix. That amounted to a 36 percent lower risk for people taking Plavix.

In an editorial in the New England journal, doctors from the Johns Hopkins University in Baltimore and the University of Texas Southwestern Medical Center in Dallas wrote that the results might have been particularly good in the European study because patients generally had a lower risk than most other sufferers.