-- Randy Dotinga
TUESDAY, Jan. 17 (HealthDay News) -- An experimental
anti-blood-clotting drug can serve as a replacement for other drugs
such as Plavix in the days before heart surgery, a new study has
The intravenous drug cangrelor appears to have the potential to
serve as a "bridge" medication for heart patients to take in the
several days before procedures such as coronary artery bypass
grafting, the study authors reported.
Anti-clotting drugs, also referred to as antiplatelet therapy or
anticoagulants -- including clopidogrel, known by the brand name
Plavix -- are often given to heart patients to prevent dangerous
vessel-clogging blood clots. But they can cause too much bleeding
during surgery, and guidelines suggest that doctors stop treatment
with them in the five to seven days before an operation.
In the new study, Dr. Dominick Angiolillo of the University of
Florida, Jacksonville, and colleagues gave cangrelor or a placebo
to 210 patients who were about to undergo coronary artery bypass
grafting. The patients had been treated with a thienopyridine (such
as Plavix) but went off the drugs prior to surgery as recommended,
then received cangrelor or placebo for at least 48 hours until one
to six hours before surgery.
Angiolillo's team found that excessive bleeding related to
surgery wasn't much more likely in the patients who took the drug
(11.8 percent) compared to those who took the placebo (10.4
percent). Major bleeding problems before surgery were rare, while
those who took cangrelor had more minor bleeding problems,
according to the report published in the Jan. 18 issue of the
Journal of the American Medical Association.
The investigators also found that the patients who took
cangrelor reached levels of platelet inhibition that are linked to
a lower risk of problems such as clots.
The findings make sense, said Dr. Gregg Stone, a heart
specialist and professor of medicine at Columbia University in New
York City. The study shows that cangrelor works rapidly and then
dissipates when it isn't needed anymore so it doesn't boost the
risk of bleeding during surgery, he said.
"This drug is investigational, so it is not yet an option for patients to ask about," Stone pointed out, "but if [the U.S. Food and Drug Administration] approved it, it would likely be widely used."
For more about
blood thinners, visit the U.S. National Library of Medicine.
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