Plavix-Aspirin Combo May Prevent Strokes and Heart Attacks; Increased Bleeding Risk Also Noted

Taking the popular blood thinner Plavix in combination with aspirin appears to better prevent strokes and heart attacks in people who are at increased risk of the cardiac problems due to a particular heartbeat abnormality, new research shows.

Plavix is the blockbuster Bristol-Myers Squibb and Sanofi-Aventis drug that has been linked to an increased risk of ulcers and gastrointestinal bleeding. However, the new scientific findings indicate the drug could be of use in treating millions of people in the United States who have atrial fibrillation.

In atrial fibrillation, the upper parts of the heart quiver instead of beating properly, a defect which allows blood to pool up and form clots that may break loose, reach the brain, and cause a stroke. An estimated 2.2 million Americans have the condition.

The use of Plavix in conjunction with aspirin is being touted as the first new treatment for atrial fibrillation in 20 years.

An Alternative to Warfarin (Coumadin)?

Atrial fibrillation is commonly treated with the blood thinner warfarin, which is sold under the brand name Coumadin. However, determining the proper dose of warfarin is difficult and may lead to life-threatening complications. Also, patients being treated with warfarin must have frequent blood tests to monitor their dose.

However, researchers may have uncovered a better alternative for the treatment of atrial fibrillation with a cocktail of Plavix – the brand name for the generic drug clopidogrel – and aspirin.

The newly released study focused on 7,554 patients in the U.S. and around the world who had not taken warfarin for treatment of atrial fibrillation. All patients were given aspirin, while half also received Plavix.

Four years later, researchers found the study group that received Plavix along with the aspirin lowered their combined risks of heart attacks, strokes, blood clots, and heart-related deaths by 11 percent. The group of patients given only aspirin reported 924 complications, compared to just 832 in the Plavix-aspirin group, according to the study.

Negative Results Also Noted

But the research, led by McMaster University in Hamilton, Ontario, Canada, was not all good news for Plavix. Researchers also noted an increased risk of serious bleeding in those patients given the anti-clotting drug — 251 cases of serious bleeding among those taking Plavix and warfarin compared to just 162 among those on aspirin alone.

Still, researchers concluded that the risks of taking Plavix along with aspirin to treat atrial defibrillation outweigh the risks, including severe bleeding.

The research findings were presented March 31, 2009 at an American College of Cardiology conference and published online by the New England Journal of Medicine.

Other Atrial Fibrillation Treatment Unveiled

At the same meeting, doctors also learned about another potential treatment for atrial fibrillation, a new and experimental heart device called the Watchman. The device is designed to prevent blood clots from reaching the brain, where they can result in deadly strokes.

An advisory panel of the Food and Drug Administration panel is set to consider whether to recommending approval of the new device on April 23, officials said.

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