The most recent issue of The Lancet contains the results of a large study in which the clot-preventing drug Plavix (clopidogrel) was added to the standard hospital care given to heart-attack patients.
While aspirin is routinely used in the emergency treatment of heart attack, Plavix is not.
The study was done in China and involved some 45,800 patients treated within 24 hours of the onset of a heart attack at 1,250 hospitals. Half of the subjects were given the standard treatment (including aspirin) while the other half was also given Plavix.
The group that received clopidogrel had a 7% lower death rate as well as a 14% lower incidence of second heart attacks during the treatment period (28 days or discharge whichever was shorter). Overall, the Plavix group had a 9% lower rate of repeat heart attacks, stroke, and death from heart attack.
In addition to these favorable results, there was no increase in excessive bleeding, a potentially dangerous problem that was feared with the combining of aspirin and Plavix.
Clopidogrel has already been shown to reduce deaths and other heart problems by 50% in heart-attack patients taking the drug before, rather than during, an angioplasty. Plavix is also used for patients with unstable angina or those undergoing the insertion of an arterial stent.
The study is seen as an excellent reason to standardize the use of Plavix as a routine part of the care given to heart-attack patients as soon as they are hospitalized.
The researchers estimate that based on the annual worldwide figure of 10 million heart attacks, the use of Plavix could save some 5,000 lives each year while also preventing the same number of heart attacks and strokes.