New drug therapy cuts risk of second heart attack

Harvard researchers have found a new treatment for heart attack that provides greater hope for the roughly one in four patients whose heart arteries remain blocked even after standard drug treatment.
The new therapy adds a fourth drug to the three-drug regimen that is frequently prescribed after a heart attack to break up clots that block arteries carrying the heart’s critical blood supply. The addition of the fourth drug – an antiplatelet medication called clopidogrel, marketed commercially under the name Plavix – reduced the odds of a second heart attack by 31 percent and also reduced the odds of dying from heart-related causes and of needing emergency bypass surgery to restore blood flow to the heart.

The three drugs frequently given after a heart attack include a clot-buster, an anticoagulant, and an antiplatelet medication, typically aspirin.

The new treatment was tested in a large-scale clinical trial run by researchers at Harvard Medical School and Harvard-affiliated Brigham and Women’s Hospital. The study’s authors said the findings represent the first advance in clot-busting drug treatment for heart attack in more than 10 years that improves mortality.

The clinical trial, supported by a grant from Sanofi-Aventis and Bristol-Myers Squibb, the makers of Plavix, followed 3,491 men and women age 75 and younger who had suffered a heart attack. The trial was conducted at 319 sites in 23 countries.

Trial subjects were treated with the standard clot-busting treatment and aspirin within 12 hours of the heart attack. They then either received clopidogrel or a placebo for the remainder of the trial.

Marc S. Sabatine, an instructor of medicine at Harvard Medical School and associate physician in Brigham and Women’s Cardiovascular Division, presented the results this week at the American College of Cardiology 54th Annual Scientific Session in Orlando, Fla. Results were also published in the New England Journal of Medicine online on Wednesday (March 9), and are scheduled to be published in the March 24 print issue.