New Drug Shows Promise in Use With Coronary Stents

SATURDAY March 29, 2008 -- Treatment with a new antiplatelet drug called prasugrel may be better than standard treatment in protecting against blocked blood flow in patients with at least one coronary stent, according to a new international study.

Coronary stents are used to treat narrowing of arteries that supply blood to the heart. But stents can result in blood clots that can block the stented artery, a condition called stent thrombosis. To prevent this, patients take antiplatelet medications or anticoagulants after they've had stents inserted in arteries. The standard treatment uses the drug clopidogrel (Plavix) with aspirin.

Both prasugrel (Effient) and clopidogrel belong to a group of compounds called thienopyridines.

In this study, Dr. Stephen Wiviott, of Brigham and Women's Hospital and Harvard Medical School in Boston, and colleagues analyzed data on 12,844 patients with different types of heart stents who were treated with either prasugrel plus aspirin or clopidogrel plus aspirin.

They found that patients who received intensive antiplatelet therapy with prasugrel had fewer "ischemic events," including stent thrombosis, than patients who received clopidogrel. The type of stent was not a factor.

"These data highlight the importance of aggressive antiplatelet therapy to reduce ischemic events in patients with acute coronary syndromes undergoing percutaneous coronary intervention," the study authors concluded. "When balancing risks and benefits of strategies to prevent ischemic events, consideration should be given to patient characteristics, including risk of bleeding and ischemic events as well as stent and procedural characteristics."

The study was to be presented Saturday at the American College of Cardiology annual meeting, in Chicago, and appears online in The Lancet. It will be published in an upcoming print issue of the journal.

More information

The U.S. National Library of Medicine has more about stents.

Posted: March 2008


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