"Super" Aspirin Does Super Job In Fighting Heart Attacks

December 21, 1998

DALLAS, Dec. 22 -- Individuals whose heart attack was treated with a type of blood-thinning drug had a 30 percent reduced risk of dying within four days, according to a study of more than 30,000 heart attack patients reported today in Circulation: Journal of the American Heart Association.

Like aspirin, the drugs called a platelet IIb/IIIa receptor blockers keep blood platelets from clumping and forming blood clots that can trigger a heart attack or stroke. However, the platelet blockers, sometimes called "super aspirins" and sold under the generic names of eptifibatide, tirofiban, and abciximab, are more potent than aspirin. They are also administered through an intravenous "drip," or infusion.

"Aspirin is valuable for treating people with heart attacks and unstable angina -- severe chest pain that is often a sign of impending heart attack," says the study's lead author, David F. Kong, M.D., fellow at the Duke Clinical Research Institute in Durham, N.C.

"This new family of drugs works harder at making platelets less sticky, and they do it to a far greater degree than many other blood-thinners we've tried in the past."

The study, conducted by researchers at Duke, the Cleveland Clinic Foundation and the Green Lane Hospital in Auckland, New Zealand, analyzed 16 studies of about 32,000 heart attack patients. Participants received the platelet blocker drugs as part of their treatment for either heart attack or severe chest pain. Some individuals in the study received only the platelet blockers while others were treated with the drug plus angioplasty -- a procedure that uses a balloon-tipped catheter to restore blood flow in the blood vessel.

The researchers investigated how well the drugs prevented heart attacks, deaths from any cause, or the need for either angioplasty or bypass surgery, which reroutes blood flow around a blocked blood vessel. The researchers examined the drugs' effectiveness at three intervals: 48-96 hours; 30 days; and six months. "At the early time points, we found a statistically significant reduction in death," Kong says. "These drugs are saving lives."

Those who received the platelet blockers had a 30 percent reduced risk of all-cause death than those who did not receive the drugs. This meant that one person's life was saved for every 1,000 treated, says Kong.

There were almost 30 fewer deaths, heart attacks, or need for repeat angioplasty or bypass for every 1,000 patients treated, and the benefits were statistically significant through six months.

"Using the drugs saves lives, reduces the number of heart attacks, and cuts down on the number of individuals who need repeat angioplasty or bypass procedures," says Kong.

The individuals who particularly benefited from the drugs were those who also were treated with angioplasty, Kong says. In these individuals, the drug was administered just as the coronary arteries were being opened by inflation of the balloon-tipped catheters used for the procedure.

Studies now are underway to test the combination of platelet blockers and clot-dissolving medicines in heart attack patients.

Although use of the drugs is increasing for selected patients in hospitals -- and individual studies have indicated benefits for the drugs -- this new study quantifies the overall advantage and shows that the benefits last for as long as six months, notes Kong.

The other "mainstay" treatment for heart attack is clot-dissolving medicine, but Kong says these drugs are suitable for only 30-50 percent of heart attack patients in hospitals. Some individuals who cannot be given clot-busters -- those with unstable angina (indicating an impending heart attack), non-Q-wave myocardial infarction (mild heart attack), or undergoing balloon angioplasty -- may instead benefit from these platelet blockers.

Other authors are Robert M. Califf, M.D.; Robert A. Harrington, M.D.; James E. Tcheng, M.D.; and Vic Hasselblad, Ph.D. of Duke; Dave P. Miller, M.S.; David J. Moliterno, M.D.; A. Michael Lincoff, M.D.; and Eric J. Topol, M.D., of the Cleveland Clinic; and Harvey D. White, M.B. Ch.B, D.Sc., of the Green Lane Hospital.
-end-
Media advisory: Dr. Kong can be reached by pager at 919-970-1508, or by phone at 919-668-8946 (Please do not publish numbers.)



American Heart Association

Related Heart Attack Articles from Brightsurf:

Top Science Tip Sheet on heart failure, heart muscle cells, heart attack and atrial fibrillation results
Newly discovered pathway may have potential for treating heart failure - New research model helps predict heart muscle cells' impact on heart function after injury - New mass spectrometry approach generates libraries of glycans in human heart tissue - Understanding heart damage after heart attack and treatment may provide clues for prevention - Understanding atrial fibrillation's effects on heart cells may help find treatments - New research may lead to therapy for heart failure caused by ICI cancer medication

Molecular imaging identifies link between heart and kidney inflammation after heart attack
Whole body positron emission tomography (PET) has, for the first time, illustrated the existence of inter-organ communication between the heart and kidneys via the immune system following acute myocardial infarction.

Muscle protein abundant in the heart plays key role in blood clotting during heart attack
A prevalent heart protein known as cardiac myosin, which is released into the body when a person suffers a heart attack, can cause blood to thicken or clot--worsening damage to heart tissue, a new study shows.

New target identified for repairing the heart after heart attack
An immune cell is shown for the first time to be involved in creating the scar that repairs the heart after damage.

Heart cells respond to heart attack and increase the chance of survival
The heart of humans and mice does not completely recover after a heart attack.

A simple method to improve heart-attack repair using stem cell-derived heart muscle cells
The heart cannot regenerate muscle after a heart attack, and this can lead to lethal heart failure.

Mount Sinai discovers placental stem cells that can regenerate heart after heart attack
Study identifies new stem cell type that can significantly improve cardiac function.

Fixing a broken heart: Exploring new ways to heal damage after a heart attack
The days immediately following a heart attack are critical for survivors' longevity and long-term healing of tissue.

Heart patch could limit muscle damage in heart attack aftermath
Guided by computer simulations, an international team of researchers has developed an adhesive patch that can provide support for damaged heart tissue, potentially reducing the stretching of heart muscle that's common after a heart attack.

How the heart sends an SOS signal to bone marrow cells after a heart attack
Exosomes are key to the SOS signal that the heart muscle sends out after a heart attack.

Read More: Heart Attack News and Heart Attack 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.