Study: Heart attacks, deaths rise after Plavix stopped

stopping Plavix has risks

Bloomberg News

Heart attacks and deaths nearly doubled after patients stopped taking the anti-clotting drug Plavix, according to the first national study documenting the risk to heart patients who end their drug therapy.

The study of more than 3,000 U.S. military veterans who had heart attacks or chest pain found their risk of another heart attack or death spiked in the 90 days after they stopped taking the medication, made by Bristol-Myers Squibb Co. and Sanofi- Aventis SA. The U.S.-funded study appears in the Feb. 6 Journal of the American Medical Association.

The findings, if confirmed, could alter care for heart attack patients treated with drugs or stents to prop open their clogged arteries, said lead researcher John Rumsfeld, a staff cardiologist at the Denver Veterans Affairs Medical Center. The research also suggests that deadly blood clots in patients with cardiac stents may sometimes be related to Plavix instead of the mesh tubes that prop open the arteries.

"In all of these situations, after you finish your course of therapy, we see this spike or an increased risk of a heart attack," Rumsfeld said in a telephone interview. "That suggests the problem may have to do with this potential rebound as opposed to a stent mechanism," since many patients didn't get a stent, he said.

About 775,000 people have mild heart attacks or chest pain known as acute coronary syndrome in the U.S. each year. One treatment involves stents from Boston Scientific Corp. or Johnson & Johnson to hold open the artery and relieve pain. Worries about stent-related blood clots led sales of the newer drug-coated devices to plunge 30 percent in the U.S. last year.

Another heart treatment is a cocktail of Plavix and other drugs, which a study last year said was as effective as stents in preventing future heart attacks and death.

Heart patients take Plavix, also known as clopidogrel, daily for nine months to a year to prevent new clots. They should talk to their doctor after finishing treatment to decide whether to continue taking Plavix, reducing the dose, switching to a different drug or stopping and watching for complications, Rumsfeld said.

The study, funded by the U.S. Department of Veterans Affairs, was conceived after a researcher's father-in-law suffered a heart attack in the days after finishing Plavix therapy. Other investigators said they knew similar stories of patients who went from healthy to the hospital after they stopped Plavix.

"This paper suggests not just from an anecdote, but from looking at thousands of patients, that this seems to be a real phenomenon," said Deepak Bhatt, a cardiologist at the Cleveland Clinic, who wasn't involved in the study. "They were on a drug that was helping them and was protective, the drug was stopped for a reason, and the benefit is gone."

The researchers examined data on 3,137 soldiers treated from October 2003 to March 2005 at 127 Veterans Affairs hospitals. More than 60 percent of the 268 second heart attacks and deaths among those given drug therapy occurred within 90 days of stopping Plavix, as did 59 percent of the 124 deaths among patients given stents.

Sphere: Related Content