Featured Research

from universities, journals, and other organizations

More potent anti-clotting drugs with angiography may benefit patients with acute chest pain

Date:
August 15, 2013
Source:
Brigham and Women's Hospital
Summary:
In a new report in patients without artery-clearing procedures, those who had an angiography followed by prasugrel (Effient) had fewer heart attacks and strokes compared to those who had an angiography followed by clopidogrel (Plavix).

Current methods to treat acute coronary syndrome conditions, such as heart attack, include artery-clearing procedures (e.g., percutaneous coronary intervention or coronary artery bypass grafting) with medications, or medications alone for those that do not undergo procedures.

Related Articles


In a new report from the TRILOGY ACS trial from Brigham and Women's Hospital (BWH) and Duke Clinical Research Institute (DCRI), in patients without artery-clearing procedures, those who had an angiography (a type of x-ray to view the inside of blood vessels) followed by prasugrel (Effient) had fewer heart attacks and strokes compared to those who had an angiography followed by clopidogrel (Plavix). Prasugel is a stronger blocker of blood-clotting cells called platelets compared to clopidogrel. This benefit of prasugrel was not seen in patients who did not have angiography.

The study will be published in the August 17, 2013 issue of The Lancet.

"These data may have implications for patient care, since the patients who seem to benefit most from intensified anti-platelet treatment are those with confirmed coronary artery disease. However, these data would need to be verified in another study before making such a recommendation," said Stephen Wiviott, MD, BWH Cardiovascular Division, lead study author.

"These results are one of the more important observations from the TRILOGYACS trial, which was set up to address the long-term use of dual anti-platelet therapy for patients managed medically after acute coronary syndrome," said E. Magnus Ohman, MD, senior investigator at the DCRI and chairman of the TRILOGY ACS trial.

There were 7,243 patients (younger than 75 years old) included in the randomized, controlled trial, which was done at more than 800 sites worldwide. Patients were randomly assigned to take clopidogrel or prasugrel. Forty-three percent of the patients enrolled in the study were given the drug after angiography, while fifty-seven percent were given the drug without having undergone angiography.

Researchers wanted to assess cardiovascular health outcomes based on angiography status and whether the effects of drug treatment on these health outcomes differed between patients who had angiography versus those who had not before enrolling in the study.

Researchers followed the patients to track cardiovascular health outcomes -- cardiovascular death, heart attack or stroke -- at 30 months.

The group of patients who had angiography and took prasugrel had fewer cardiovascular deaths, heart attacks or strokes compared to those who had angiography and took clopidogrel. However, for patients whose condition was managed first with medicines only and no angiography, there was no clear benefit of one drug over the other.

"This study supports the potential benefit of strong anti-platelet medications in patients with heart attacks where there are known blockages in heart arteries demonstrated by angiography, and reaffirms the value of cardiac catheterization in the management and triage of patients with acute chest pain," said Deepak L. Bhatt, MD, MPH, VA Boston Healthcare System and BWH Cardiovascular Division, senior study author.

Similarly, Wiviott added, "Patients should discuss with their doctors whether heart procedures such as angiography are right for them and which medications they should use to help reduce the chance of recurrent events."


Story Source:

The above story is based on materials provided by Brigham and Women's Hospital. Note: Materials may be edited for content and length.


Journal Reference:

  1. Stephen D Wiviott, Harvey D White, E Magnus Ohman, Keith AA Fox, Paul W Armstrong, Dorairaj Prabhakaran, Gail Hafley, Yuliya Lokhnygina, William E Boden, Christian Hamm, Peter Clemmensen, Jose C Nicolau, Alberto Menozzi, Witold Ruzyllo, Petr Widimsky, Ali Oto, Jose Leiva-Pons, Gregory Pavlides, Kenneth J Winters, Matthew T Roe, Deepak L Bhatt. Prasugrel versus clopidogrel for patients with unstable angina or non-ST-segment elevation myocardial infarction with or without angiography: a secondary, prespecified analysis of the TRILOGY ACS trial. The Lancet, 2013; 382 (9892): 605 DOI: 10.1016/S0140-6736(13)61451-8

Cite This Page:

Brigham and Women's Hospital. "More potent anti-clotting drugs with angiography may benefit patients with acute chest pain." ScienceDaily. ScienceDaily, 15 August 2013. <www.sciencedaily.com/releases/2013/08/130815203717.htm>.
Brigham and Women's Hospital. (2013, August 15). More potent anti-clotting drugs with angiography may benefit patients with acute chest pain. ScienceDaily. Retrieved December 22, 2014 from www.sciencedaily.com/releases/2013/08/130815203717.htm
Brigham and Women's Hospital. "More potent anti-clotting drugs with angiography may benefit patients with acute chest pain." ScienceDaily. www.sciencedaily.com/releases/2013/08/130815203717.htm (accessed December 22, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Monday, December 22, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Christmas Kissing Good for Health

Christmas Kissing Good for Health

Reuters - Innovations Video Online (Dec. 22, 2014) Scientists in Amsterdam say couples transfer tens of millions of microbes when they kiss, encouraging healthy exposure to bacteria. Suzannah Butcher reports. Video provided by Reuters
Powered by NewsLook.com
Brain-Dwelling Tapeworm Reveals Genetic Secrets

Brain-Dwelling Tapeworm Reveals Genetic Secrets

Reuters - Innovations Video Online (Dec. 22, 2014) Cambridge scientists have unravelled the genetic code of a rare tapeworm that lived inside a patient's brain for at least four year. Researchers hope it will present new opportunities to diagnose and treat this invasive parasite. Matthew Stock reports. Video provided by Reuters
Powered by NewsLook.com
Touch-Free Smart Phone Empowers Mobility-Impaired

Touch-Free Smart Phone Empowers Mobility-Impaired

Reuters - Innovations Video Online (Dec. 21, 2014) A touch-free phone developed in Israel enables the mobility-impaired to operate smart phones with just a movement of the head. Suzannah Butcher reports. Video provided by Reuters
Powered by NewsLook.com
Earthworms Provide Cancer-Fighting Bacteria

Earthworms Provide Cancer-Fighting Bacteria

Reuters - Innovations Video Online (Dec. 21, 2014) Polish scientists isolate bacteria from earthworm intestines which they say may be used in antibiotics and cancer treatments. Suzannah Butcher reports. Video provided by Reuters
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:

Strange & Offbeat Stories


Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins