Saturday, February 16, 2008

Recent Heart Attack? - Take Your Clopidogrel!

Current guidelines recommend taking Plavix (clopidogrel) for 1 year following a heart attack. But what happens at the end of that period? A recent VA study suggests that there is a sort of "rebound period" at the end of clopidogrel therapy that might increase risk.

Specifically, among 3000 patients split between medical therapy and stenting, analysis showed a nearly twofold increase in risk for adverse events during the first 90 days after clopidogrel cessation. The theory is that platelets may become temporarily re-activated, leading to recurrent risk of thrombosis within the artery. The study has some limitations in that it involved a retrospective review of charts, but it does prompt certain steps to be taken by patient and physician:

First, be sure to complete your Plavix therapy for the full duration and then move seamlessly into aspirin therapy as directed. Second, if you have risks for recurrent arterial clogging, like multiple past stents, diabetes, or other uncontrolled risk factors, ask your doctor if extending Plavix therapy is reasonable. Better yet, control those risk factors as we discuss on the Blog!

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