Treating patients who experience a severe heart attack with Sanofi-Aventis and Bristol-Myers Squibb’s super-aspirin, Plavix (clopidogrel), can help keep arteries open and reduce the risk of suffering a second heart attack, according to new data from the companies.

These patients are frequently treated with a clot-buster, together with an anticoagulant and aspirin to dissolve the clot that is blocking the coronary artery and reduce death morbidity and mortality – however, even after therapy, 20% to 25% of patients still have a blocked artery, putting them at continued risk of death.

The trial in question included almost 3,500 men and women aged 75 years or younger, all of whom were treated within 12 hours of reaching hospital having suffered a heart attack because of a clogged artery with the standard therapy together with either Plavix or placebo. Those receiving the former experiencing a 36% reduction in the risk of having a blocked coronary artery, dying or having a second heart attack, versus 22% for those receiving standard therapy alone. In addition, Plavix treatment resulted in a 31% reduction in the odds of a recurrent heart attack and a 20% reduction in the odds of the composite of death from cardiovascular causes. The rate of major bleeding in the Plavix group was 1.3% – similar to the 1.1% in the placebo group – and the addition of Plavix did not increase the risk of intracranial haemorrhage, a rare but dangerous complication of therapy.

“We have demonstrated that the addition of [Plavix] to standard therapy in patients experiencing an acute myocardial infarction significantly increases the odds of having and maintaining an open coronary artery,” the trial’s author, Marc Sabatine, stated. “[Plavix] offers an effective, simple, inexpensive and safe means by which to improve reperfusion and prevent further damage to the heart in these high-risk patients.”

Heart attacks affect 10 million patients worldwide each year, of whom four million have severe attacks due to a completely blocked coronary artery that requires clot-busting medication or emergent angioplasty. Plavix boasts annual sales of around $5 billion dollars, growing at a rate of 31% per year [[10/03/05f]]. However, it is currently facing a challenge from generics manufacturer, Dr Reddy’s, which is waiting in the wings with a copycat version of the product [[25/02/05g]].