New Drug Thins Blood Better Than Plavix

Nov. 5, 2007 — -- For years doctors have known that thinning the blood, using drugs such as aspirin, can reduce heart attacks. So for years they have used a super aspirin, Plavix, to prevent heart attacks in patients who have angioplasty, and are at greater risk for developing clots.

Today at the country's biggest heart meeting, heart specialists heard about a new drug called Prasugrel, even more powerful at blood thinning than Plavix. A new study of more than 13,000 patients found that Prasugrel significantly reduced cardiovascular complications, including clots in stents.

The lead investigators of the so-called TRITONTIMI 38 study said their data suggested that 96 percent of patients who were high risk for heart events and were having a stent could be potential candidates for this drug, which is not yet approved.

Many heart specialists at the American Heart Association Scientific Sessions in Orlando, Fla., Sunday were enthusiastic about the success of the drug, which reduced the number of heart events in the study participants from 19 percent to as much as 50 percent.

"This is the first validation that more-powerful oral anti-platelet drugs further reduce coronary complications," said Deepak Bhatt, associate director of the cardiovascular coordinating center at Cleveland Clinic, who wrote the editorial accompanying the study in the New England Journal of Medicine.

However, in the world of anti-platelet therapies, more isn't always better.

Heart specialists spent the day debating whether the price for this success at blood thinning was too high. The more powerful ability to thin the blood means that the drug also causes various kind of bleeding, some of which can be fatal. Major bleeding happened in 2.4 percent of patients receiving Prasugrel and 1.8 percent receiving Plavix.

"I think the bleeding was too excessive to warrant immediate use of this new agent," said Adolph Hutter, associate director of the coronary care unit at Massachusetts General Hospital.