Popular anti-platelet therapy reduces risk of cardiovascular events in men and women

November 09, 2009

A new study, published in the November 17, 2009, issue of the Journal of the American College of Cardiology, adds to a growing body of research seeking to evaluate and understand possible sex differences associated with antiplatelet therapies. This study--the first to look at the impact of clopidogrel, one of the most frequently prescribed drugs to prevent and treat heart disease, in women--found it to be effective in reducing cardiovascular (CV) events in both men and women with no statistically significant sex differences in terms of expected clinical benefit or increased harm.

Clopidogrel reduced cardiovascular events by 16 percent in men compared to 7 percent in women; however, this difference was not statistically significant. Although there was a clear reduction in the risk of CV events in both sexes, women derived the most benefit from a decrease in their risk of heart attack with a nonsignificant reduction in stroke and total death. Data show a small, but real excess risk of major bleeding with clopidogrel therapy in both men and women; adding clopidogrel to aspirin therapy resulted in a 43 percent and 21 percent increased risk of major bleeding in women and men, respectively.

According to the authors, by treating 1,000 men and 1,000 women with clopidogrel on a background of aspirin for an average of eight months, clinicians can prevent eight cardiovascular events in women and 12 in men; from a safety perspective, there would be five major bleeding incidents in women and two in men.

Researchers performed a meta-analysis of five major clinical trials to evaluate the clinical benefit and risk of this antiplatelet therapy in women and men and determine whether there are sex-based differences in treatment response. Nearly 80,000 individuals with a broad range of CV diseases were enrolled in these trials, 30 percent of whom were women. Lead investigators of the five double-blinded, randomized placebo-controlled trials shared original study data with authors.

Clopidogrel works to disrupt platelet activity and prevents them from clotting and causing heart attacks and strokes. It is typically used in patients with heart attacks, those at increased severity of angina, and in patients following stent implantation. It is also commonly used in those with established CV disease.

Women have traditionally been underrepresented in clinical trials enrollment. As newer, more potent platelet therapies are being developed, it will be important to continue to examine whether sex differences exist in the therapeutic effect of these drugs. According to the accompanying editorial, research to examine the impact of sex on responses to cardiovascular treatment should be ongoing, especially as the decrease in deaths related to heart disease has been less for women and has actually increased in women younger than 55 years of age since 1980 despite progress in reducing associated morbidity and mortality.
-end-
The American College of Cardiology is leading the way to optimal cardiovascular care and disease prevention. The College is a 37,000-member nonprofit medical society and bestows the credential Fellow of the American College of Cardiology upon physicians who meet its stringent qualifications. The College is a leader in the formulation of health policy, standards and guidelines, and is a staunch supporter of cardiovascular research. The ACC provides professional education and operates national registries for the measurement and improvement of quality care. More information about the association is available online at www.acc.org .

The American College of Cardiology (ACC) provides these news reports of clinical studies published in the Journal of the American College of Cardiology as a service to physicians, the media, the public and other interested parties. However, statements or opinions expressed in these reports reflect the view of the author(s) and do not represent official policy of the ACC unless stated so.

American College of Cardiology

Related Heart Disease Articles from Brightsurf:

Cellular pathway of genetic heart disease similar to neurodegenerative disease
Research on a genetic heart disease has uncovered a new and unexpected mechanism for heart failure.

Mechanism linking gum disease to heart disease, other inflammatory conditions discovered
The link between periodontal (gum) disease and other inflammatory conditions such as heart disease and diabetes has long been established, but the mechanism behind that association has, until now, remained a mystery.

New 'atlas' of human heart cells first step toward precision treatments for heart disease
Scientists have for the first time documented all of the different cell types and genes expressed in the healthy human heart, in research published in the journal Nature.

With a heavy heart: How men and women develop heart disease differently
A new study by researchers from McGill University has uncovered that minerals causing aortic heart valve blockage in men and women are different, a discovery that could change how heart disease is diagnosed and treated.

Heart-healthy diets are naturally low in dietary cholesterol and can help to reduce the risk of heart disease and stroke
Eating a heart-healthy dietary pattern rich in vegetables, fruits, whole grains, low-fat dairy products, poultry, fish, legumes, vegetable oils and nuts, which is also limits salt, red and processed meats, refined-carbohydrates and added sugars, is relatively low in dietary cholesterol and supports healthy levels of artery-clogging LDL cholesterol.

Pacemakers can improve heart function in patients with chemotherapy-induced heart disease
Research has shown that treating chemotherapy-induced cardiomyopathy with commercially available cardiac resynchronization therapy (CRT) delivered through a surgically implanted defibrillator or pacemaker can significantly improve patient outcomes.

Arsenic in drinking water may change heart structure raising risk of heart disease
Drinking water that is contaminated with arsenic may lead to thickening of the heart's main pumping chamber in young adults, according to a new study by researchers at Columbia University Mailman School of Public Health.

New health calculator can help predict heart disease risk, estimate heart age
A new online health calculator can help people determine their risk of heart disease, as well as their heart age, accounting for sociodemographic factors such as ethnicity, sense of belonging and education, as well as health status and lifestyle behaviors.

Wide variation in rate of death between VA hospitals for patients with heart disease, heart failure
Death rates for veterans with ischemic heart disease and chronic heart failure varied widely across the Veterans Affairs (VA) health care system from 2010 to 2014, which could suggest differences in the quality of cardiovascular health care provided by VA medical centers.

Heart failure: The Alzheimer's disease of the heart?
Similar to how protein clumps build up in the brain in people with some neurodegenerative diseases such as Alzheimer's and Parkinson's diseases, protein clumps appear to accumulate in the diseased hearts of mice and people with heart failure, according to a team led by Johns Hopkins University researchers.

Read More: Heart Disease News and Heart Disease Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.