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DG DISPATCH - ACC: Plavix (Clopidogrel) Superior To Aspirin For Preventing Acute Coronary Events By Edward Susman Special to DG News ANAHEIM, CA -- March 16, 2000 -- Researchers analyzing data from the CAPRIE trial have determined that combining cholesterol-lowering drugs with the platelet aggregation inhibitor, clopidogrel (Plavix), instead of aspirin substantially reduces the risk of acute coronary syndromes. Investigators from The Cleveland Clinic Foundation reported an overall risk reduction of 18.6 percent with clopidogrel compared with aspirin in the combined endpoints of heart attack and stroke, mini-strokes, need for hospitalization, excessive bleeding and death due to blood vessel disease. "Clopidogrel is superior to aspirin in patients with heart disease who are also on cholesterol-lowering therapy," Deepak Bhatt, MD, a cardiologist at the Cleveland Clinic, said on March 15, 2000, at the annual scientific session of the American College of Cardiology in Anaheim, CA. "Furthermore, the benefit of anti-platelet therapy with clopidogrel appears to be independent and complementary to benefits provided by cholesterol-lowering," Bhatt and colleagues analyzed data from the 19,000-patient CAPRIE (Clopidogrel Versus Aspirin in Patients at Risk of Ischemic Events) study, that established clopidogrel as being superior to aspirin in heart disease prevention. They specifically looked at how 1,080 patients who had high cholesterol and were receiving cholesterol-lowering drugs and clopidogrel compared with 1,014 similar patients who were receiving aspirin. Dr. Bhatt reported that patients on the combination with clopidogrel reduced their risk of: - death, heart attack and stroke by 34.1 percent. - heart attack and stroke by 44.1 percent. - heart attack by 56 percent. "Aggressive use of clopidogrel has the potential to reduce heart attack and stroke in a significant percentage of these high-risk patients," Dr. Bhatt said. He added that it might be possible to even enhance those results by a triple combination of cholesterol-lowering drugs, aspirin and clopidogrel. Jonathan Abrams, MD, professor of medicine at the University of New Mexico, in Albuquerque, NM, said that when the results showing the benefit of clopidogrel over aspirin first were published, many doctors were unimpressed by the 9 percent superiority. However, he said that as the data in the study are analyzed, a greater appreciation has developed of the properties of the drug to favorably affect heart disease treatment. In addition to its effects in Dr. Bhatt's study, Dr. Abrams noted that clopidogrel is also the drug of choice in treating patients undergoing most angioplasty procedures. Related Links: clopidogrel (Plavix) and aspirin. E-mail this page to a friend or colleague! To print, use this version