Plavix plus Aspirin a Risky Combination
- From: MarchHare1947@xxxxxxxxx (B B)
- Date: Mon, 13 Mar 2006 21:59:43 -0600
I just read this article from the homepage for my webtv and am plenty
worried about it.
I have been taking aspirin since I started having strokes well over a
year ago. When my neurologist did an MRI on my head to look for signs of
MS and found numerous signs of more small strokes since the larger ones,
he added Plavix to my meds. Since then, I have bled easier and easier,
having a tiny nick on my elbow resulting in blood running down the front
of my blouse and in puddling my lap, for instance.
Now, after reading this, I'm wondering if I'm having more problems with
the combination than just the bleeding. Should I be concerned? Should I
contact my neurologist about my concerns and tell him that I had read
the article? Should I just ignore everything and just continue to go on
as if nothing was happenning?
Also, for at least a week, I've had an extreme, sharp pain in my
shoulder with the minimal movement. I thought it was probably a pinched
nerve and had hoped it would resolve itself. It is at the same level of
pain as it was in the beginning. A couple of days ago, I found a
fair-sized bruise on the back of my shoulder in about the same place as
the major pain. Would the easy bleeding be causing the problem, or could
the bruise be a sign of injury to the shoulder? I already had a
partially torn rotator cuff on that side, but it has stayed status quo
for ages. Are there any recommendations about what I should do? I'm
confused.....obviously.
Article
******************************************************
Blood thinner plus aspirin a risky combination - Heart Health -
MSNBC.com
Plavix plus aspirin a risky combination
Popular duo used for prevention instead doubles chance of heart attack
ATLANTA - Some people taking the blood thinner Plavix on top of aspirin
to try to prevent heart attacks, as many doctors recommend, now have
good reason to stop.
The drug combination not only didn't help most people in a newly
released study, but it unexpectedly almost doubled the risk of death,
heart attack or stroke for those with no clogged arteries but with
worrisome conditions like high blood pressure and high cholesterol.
"They actually were harmed," said Dr. Eric Topol.
"This was a trial to determine the boundaries of benefit, and it did.
You don't use this drug for patients without coronary artery disease."
Nothing in the study changes recommendations that people who recently
have had heart attacks or a procedure to unclog an artery take those
medicines. This study dealt with expanding use of the drug to other
people.
Topol and Dr. Deepak Bhatt of the Cleveland Clinic led the study, which
involved 15,603 people in 32 countries. Topol has since left the clinic
and is at Case Western Reserve University in Cleveland. Results were
reported Sunday at an American College of Cardiology conference whose
organizers issued an "expression of concern" saying the drug's maker,
Sanofi-Aventis SA, told some stock analysts the results of the study in
advance, in violation of the conference's embargo policies.
However, Sanofi spokesman Michel Joly denied the claim Sunday, saying
the company provided no results in advance. Aspirin alone sufficient
Aspirin's ability to prevent heart attacks in men is legendary but it
does little for their risk of stroke. In women, aspirin wards off
strokes but only reduces heart attack risk in those 65 or older. Adding
Plavix to aspirin for people being treated for a heart attack cuts their
risk of a second one or death.
For these reasons, doctors thought the drug combination might prevent
"heart attacks waiting to happen" in people with very clogged arteries
or lots of risk factors like heavy smoking, diabetes and high
cholesterol.
They gave everyone in the study low daily doses of aspirin plus Plavix
or a dummy pill and looked at how they fared more than two years later.
Adding Plavix made little difference for the group as a whole except for
slightly reducing hospitalizations. But for the 20 percent with no signs
of heart disease, the drug combination proved dangerous. Heart-related
deaths almost doubled, from 2.2 percent of those taking only aspirin to
3.9 percent of those who added Plavix.
The only people even modestly helped by adding Plavix were those with
established heart disease. Their risk of heart attack, stroke or death
was about 7 percent versus 8 percent for those taking aspirin alone.
Specialists said this was not enough to justify recommending the drug in
light of the overall findings of no benefit.
The cost and risks of Plavix don't justify expanding its use for
prevention, Dr. Marc Pfeffer of Brigham and Women's Hospital in Boston
and Dr. John Jarcho of the New England Journal of Medicine write in an
editorial in the journal, which will be published along with the study
results in the April 20 issue.
"Plavix should not be used for prevention," said Dr. Elizabeth Nabel,
director of the National Heart, Lung and Blood Institute. "Aspirin alone
is sufficient."
The study was paid for by Sanofi and Bristol-Myers Squibb, which sell
Plavix in the United States for about $4 a pill. Outside the U.S. the
drug is sold as Iscover. Many of the researchers have ties to the
companies or others that make heart drugs. Also at the conference, the
third study in roughly a year confirmed that a different strategy to
prevent heart attacks - folic acid and vitamin B supplements - doesn't
work.
These lower homocysteine, a blood substance that can make arteries
stiffen and clog.
Dr. Eva Lonn of McMaster University in Hamilton, Ontario, and colleagues
gave 5,522 people with clogged arteries or diabetes these vitamins or
phony pills for five years.
Homocysteine dropped in people given the supplements, but not the risk
of heart attack or death. Vitamin takers suffered slightly fewer strokes
than the others, but they also were more likely to be hospitalized for
chest pains.
Results were released by the New England Journal, which will publish
them in print later.
© 2006 The Associated Press.
http://www.msnbc.msn.com/id/11807907/
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