In a nutshell
This papers studied compared treatment with 3 drugs and treatment with 2 drugs in patients who had coronary stents (mesh wire tube) inserted.
Some background
Long-term oral anticoagulants are a group of drugs used to prevent blood from sticking together. This is an essential treatment for preventing complications in patients with irregular heartbeat and preventing stroke or heart attack. It is also used after patients receive a stent, which treats narrowed blood vessels. An example of an oral anticoagulation is warfarin. Clopidogrel (Plavix) and aspirin (acetylsalicylic acid) are drugs that prevents blood cells from sticking together.
Previous studies indicate that treatment with an oral anticoagulant plus clopidogrel led to fewer bleeding complications than treatment with oral anticoagulation, clopidogrel and aspirin.
Methods & findings
The current study compared the use of three treatments versus two treatments.
16 studies were analyzed. There were a total of 9185 patients, with 5680 patients receiving 3 drugs and 3505 patients receiving 2 drugs.
Treatment with 3 drugs did not significantly increase the risk of a major adverse cardiovascular event (complication involving the heart) compared to treatment with 2 drugs. Treatment with 3 drugs did not significantly change the risk of death, heart attack and blood clots after stent insertion compared to treatment with 2 drugs.
Treatment with 3 drugs was associated with a 43% decreased risk of stroke (decreased blood flow to the brain). The likelihood of a major bleeding occurring, however, was 52% higher in patients receiving 3 drugs than in patients receiving 2 drugs.
The bottom line
The authors concluded that treatment with an oral anticoagulant plus clopidogrel was similar overall in efficacy and safety compared to treatment with 3 drugs. Three treatments decreased the risk of stroke, but increased the risk of bleeding.
Published By :
Clinical cardiology
Date :
May 12, 2015
