What Can Plavix and Aspirin Do For Heart Disease Patients With AF?

A blood thinner, a common name for an anticoagulant agent, is a drug used to prevent formation of blood clots by hindering coagula. Blood thinner does not really thin the blood; it just prevents the blood from clotting. Doctors usually prescribe blood thinners to heart disease patients who are at risk for heart attack and stroke.

So far, anticoagulants such as warfarin and aspirin have been the only effective therapies in treating heart disease patients suffering from atrial fibrillation (AF). AF is a condition in which the heart's 2 upper chambers, the atria, quiver instead of beating effectively. This will raise the risk of blood clotting or pooling in the chambers that could eventually trigger a heart attack or stroke.

According to the American Heart Association (AHA), there are some 2.2 million Americans suffer from AF. These patients often need to be fitted with a pacemaker. Yet many of them cannot be treated with warfarin to stop blood clotting because warfarin increases the risk of an internal hemorrhage by up to 70 percent.

At the annual conference of the American College of Cardiology in Orlando on March 31, 2009, researchers from Ontario's McMaster University revealed that they managed to help AF patients cut the risk of heart attack and stroke by combining Plavix with aspirin.

Plavix is known under the generic name of clopidogrel. It is used to prevent the platelets in blood from coagulating and forming clots.

ACTIVE-A, a clinical trials involving 7,554 patients, aimed to determine whether the addition of clopidogrel to aspirin could reduce major vascular events and stroke in AF patients at an acceptable risk of increased hemorrhage. In the trials, the researchers showed that combination of Plavix and aspirin could help AF patients who are unable to take other blood thinners like warfarin.

The combination of clopidogrel and aspirin reduced major vascular events by 11 percent, including a 28 percent reduction in stroke and a 23 percent reduction in myocardial infarction (also known as heart attack), as found in the study.

It is believed that this is a new treatment for AF for the first time in 20 years.

Drugs Combination Could Raise The Risk of Another Heart Attack!

It is common practice for doctors to prescribe blood-thinning medication such as Plavix or aspirin together with a proton pump inhibitor (PPI) like Prilosec to their patients who had heart attack.

Plavix is also known as clopidogrel, and is manufactured by Sanofi-Aventis SA and Bristol-Myers Squibb Co. On the other hand, Prilosec is a drug for heartburn and is product of AstraZeneca Plc. The purpose of taking PPI is to cut the risk of gastrointestinal bleeding from blood thinners.

However, the latest research showed that people who suffer a heart attack will nearly double their chance of getting another if they are taking Plavix together with a heartburn drug.

A study conducted by researchers from the Denver VA Medical Center indicated that two-thirds of the heart attack patients who took Plavix and aspirin together with a PPI, primarily Prilosec, had almost double the risk of having another heart attack or bout of unstable angina, comparing with those not taking a PPI. Their findings were published on March 3, 2009 in the Journal of the American Medical Association.

In the study, the researchers tracked some 8,205 United States patients, who were treated for a heart attack or chest pain known as unstable angina, and who were given Plavix and aspirin. The study highlighted a potential interaction between clopidogrel and PPI medication, and the researchers believed that this drug combination might be responsible for thousands of repeat heart attacks.

Therefore, they suggested that PPI medication should not just be prescribed routinely or prophylactically in patients who are on aspirin and clopidogrel.

Nevertheless, the findings have not been widely accepted among medical circles and some doctors actually express their worries. If PPIs are not prescribed for heart attack patients, it is possible that more bleeding complications would occur among the patients. It is undeniably that a big bleed for a patient with significant coronary artery disease could be fatal.

As such, some doctors urged caution regarding the findings. Perhaps, more studies should be carried out to strengthen the findings and better still to look for alternative ways of treatment.