Drug Plus Aspirin Aids ED Heart Patients

The study appeared in the February 18, 2003, online rapid access issue of Circulation.

Emergency department doctors studied 12,562 patients with unstable angina or non-ST segment elevation heart attack, which are known as acute coronary syndromes (ACS). The average age of the patients was 64, and 38% were women. They received either clopidogrel or placebo, and all received aspirin. Those patients given clopidogrel displayed a beneficial effect within hours of the first dose. After 30 days, 6.3% of those given placebo suffered a major event, versus 5.2% in the clopidogrel group, an 18% difference.

Patients given clopidogrel had no excess of life-threatening bleeds but did have an excess of nonlife-threatening bleeds. The researchers, however, say the benefits of the drug far outweighed the risk of bleeding.

"Other than aspirin, clopidogrel is the only antithrombotic agent that has shown a benefit both in the early phase and during long-term treatment of acute coronary syndromes,” said co-author Shamir R. Mehta, M.D., assistant professor of medicine at McMaster University (Hamilton, Canada).




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