The study shows that "the effort to use powerful antiplatelet drugs to make the outcome better for patients who have heart attacks should be abandoned," said study author Dr. Stephen G. Ellis, a professor of medicine at the Cleveland Clinic. Platelets are the blood cells that clump together to form blood clots.
"There might be a very modest benefit for high-risk patients in terms of the size of the heart attack, but it seems to be offset by the increase in bleeding risk," Ellis said. "Based on present information, it is difficult to advocate it for any patients."
However, a second report in the same journal said a study established the value of using a newer kind of anti-clotting drug, bivalirudin, during PCI after a heart attack.
The study of 3,602 people given PCI within 12 hours of a heart attack found that using bivalirudin rather than the older, established anti-clotting therapy reduced the incidence of major complications and death.
The overall death rate in the following 30 days for those given bivalirudin was 2.1 percent, compared to 3.1 percent for those given the older anti-clotting treatment.
"I would expect this to become the standard of care," said study author Dr. Gregg W. Stone, a professor of medicine at Columbia University in New York City. "This is the first study of bivalirudin to show a reduction of mortality in a large randomized trial. Whenever you save lives, it is a major finding."
Bivalirudin is safer, because "it avoids all major bleeding complications, which are directly related to mortality," Stone said.
More information
Learn more about percutaneous coronary intervention from the American Heart Association.
