Navigation Links
Aspirin Alone Works Best to Prevent Clots a Year After Stenting

Adding Plavix didn't boost outcomes after 12 months, new study finds

MONDAY, March 15 (HealthDay News) -- After 12 months, giving aspirin alone to patients who have had stents implanted seems just as good as giving aspirin along with the blood thinner Plavix, a new study finds.

Researchers discovered that, after an initial year receiving the dual anti-clotting therapy, patients who went off Plavix and just took aspirin had the same rate of heart attacks and death as those patients continuing on the two drugs together.

The findings are unlikely to change what is happening in clinics, however.

"In general, this fits with current guidelines so it's not going to be practice-changing per se," said. Dr. Gurpreet Sandhu, an interventional cardiologist with the Mayo Clinic in Rochester, Minn. "The current guidelines from the American Heart Association and the American College of Cardiology indicate that people need to be on dual anti-platelet therapy for at least one full year after stent placement and then aspirin after that indefinitely."

"I don't think this trial will have any impact on practice in North America and I frankly hope that it won't because there's just not enough that we can draw out of this single trial to clarify what we ought to be doing in North American patients," added Dr. Kirk Garratt, clinical director of interventional cardiovascular research at Lenox Hill Hospital who, like others, is waiting for results from other major trials.

The study is to be presented Monday at the American College of Cardiology annual meeting in Atlanta and will also be published in the March 18 issue of the New England Journal of Medicine.

The U.S. Food and Drug Administration also recommends that patients get the combination therapy for at least 12 months after receiving a stent, Garratt said.

"After 12 months, it's dealer's choice. We don't have any good information to guide us," he said.

The study was led by researchers at the University of Ulsan College of Medicine, Asian Medical Center in Seoul, Korea, who also called for more trials to confirm or refute the data.

Stents are inserted to prop open arteries that have become narrowed due to plaque build-up. Once in place, though, the stents - tiny mesh scaffolds - can help spur dangerous blood clots.

These new results come not from one study but from two initially separate studies which were combined because both had flagging enrollment.

In all, more than 2,700 Korean patients were randomly assigned to receive clopidogrel (Plavix) plus aspirin for at least 12 months. Patients were followed for a median of just over 19 months.

Not only were there few differences between the two groups, there was even a sign of benefit in the group taking aspirin alone after 12 months.

"This was surprising [that there was no difference between the arms] and that those on aspirin alone even seemed to do a little bit better with respect to heart attack, stroke and death," Garratt said.

Nor were bleeding complications, always a concern with blood-thinning medications, any different between the two groups.

It is conceivable, however, that the results would not hold up in a different study population.

For instance, Asian populations have a high prevalence of an enzyme which is not very good at metabolizing Plavix, Garratt pointed out. The individuals studied here were likely all or nearly all Asian.

"It's likely that the Plavix group didn't have the same effect biochemically that we would have expected in a North American, Caucasian or mixed population," he said.

"This study essentially shows that you need to continue aspirin and clopidogrel for one full year and after that, you can stop clopidogrel and just keep people on aspirin and that is what people have been doing in general," Sandhu said. "There are some people who are concerned about the risk of clot formation on stents even beyond one year so many cardiologists and patients do continue with both aspirin and clopidogrel well beyond one year. [But], in the majority of cases, one year is all that is needed."

Plavix has long been the leader in clot-busting drugs, although new agents are now vying to take its place.

More information

There's more on blood thinners at the American Heart Association.

SOURCES: Kirk Garratt, M.D., clinical director, interventional cardiovascular research, Lenox Hill Hospital, New York City; Gurpreet Sandhu, M.D., Ph.D., interventional cardiologist, Mayo Clinic, Rochester, Minn.; March 15, 2010, presentation, American College of Cardiology annual meeting, Atlanta; March 18, 2010, New England Journal of Medicine

Copyright©2010 ScoutNews,LLC.
All rights reserved

Related medicine news :

1. Cardiologists Comment on Aspirin Versus Resveratrol
2. Aspirin May Boost Breast Cancer Survival
3. Aspirin During Pregnancy May Help Preemies
4. Three Anticoagulant Studies May Change Current Medical Practice Including New Data Revealing That Preventative Use of Aspirin and Heparin is Not Effective in Reducing Recurrent, Unexplained Miscarriages
5. In Women, Aspirin Might Ward Off Eye Trouble
6. News brief: Effects of aspirin and folic acid on inflammation markers for colorectal adenomas
7. Aspirin misuse may have made 1918 flu pandemic worse
8. Postdiagnosis aspirin use reduces risk of dying from colorectal cancer
9. Aspirin May Stem Deaths From Colorectal Cancer
10. Corgenix to Exhibit AspirinWorks(R) Test at 2009 ISTH Meeting
11. Drug Limits Stomach Trouble in Patients Taking Low-Dose Aspirin
Post Your Comments:
(Date:6/24/2016)... Fla. (PRWEB) , ... June 24, 2016 , ... Global ... Trend magazine’s 2016 Legal Elite. The attorneys chosen by their peers for this recognition ... Florida. , Seven Greenberg Traurig Shareholders received special honors as members of this year’s ...
(Date:6/24/2016)... ... , ... Comfort Keepers® of San Diego, CA is excited to announce they ... to drive cancer patients to and from their cancer treatments. Comfort Keepers provides ... life and ongoing independence. Getting to and from medical treatments is one of ...
(Date:6/24/2016)... ... June 24, 2016 , ... People across the U.S. are sharpening their pencils ... an essay contest in which patients and their families pay tribute to a genetic ... 2016 National Society of Genetic Counselors (NSGC) Annual Education Conference (AEC) this September. ...
(Date:6/24/2016)... ... 24, 2016 , ... The Haute Beauty Network, affiliated with ... as a prominent plastic surgeon and the network’s newest partner. , Dr. ... handsome men, look naturally attractive. Plastic surgery should be invisible.” He stands by ...
(Date:6/24/2016)... ... 24, 2016 , ... Strategic Capital Partners, LLC (SCP) in ... investment capital for emerging technology companies. SCP has delivered investment events and ... more than a million dollars of capital investment for five companies. ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... 23, 2016 Research and Markets has ... - Forecast to 2022" report to their offering. ... for the patients with kidney failure, it replaces the function ... the patient,s blood and thus the treatment helps to keep ... in balance. Increasing number of ESRD patients ...
(Date:6/23/2016)... Research and Markets has announced the addition of the ... to 2022" report to their offering. ... financial data derived from varied research sources to present unique ... on the market during the next five years, including a ... markets, regional and country level analysis. The report provides a ...
(Date:6/23/2016)... RIDGE, Ill. and INDIANAPOLIS ... of students receiving a Lilly Diabetes Tomorrow,s Leaders Scholarship ... The 2016 scholarship winners, announced today online at ... to let type 1 diabetes stand in the way ... Diabetes has supported the Foundation,s scholarship program since 2012, ...
Breaking Medicine Technology: