THURSDAY, Aug. 14 (HealthDay News) -- Giving a high dose of the
anti-clotting drug tirofiban to heart attack victims while on route
to the hospital could improve their chances of survival, a new
report says.
The study, published in a special cardiology issue of
The Lancet this week, showed that patients given tirofiban in
addition to the standard triple treatment of the anti-clotting
agents aspirin, heparin and clopidogrel had significant less
blockage affecting their heart than those given only the three
standard medicines and a placebo.
The researchers -- lead by Arnoud van't Hof, Isala Klinieken of
the department of cardiology, Zwolle, Netherlands -- found that
major bleeding did not differ significantly between the two groups
(4 percent of patients in the tirofiban group and 3 percent in
standard group).
"Our trial was not powered on a difference in clinical outcome
between the two groups. However, we noted a better clinical outcome
in the tirofiban group than in the placebo group, with lower
overall mortality and less urgent repeat [primary coronary
angioplasty]," the authors wrote.
In an accompanying comment, Gilles Montalescot of the Institute
of Cardiology Piti-Salptrire Hospital, INSERM 856 and University of
Paris 6, Paris, wrote that the study "reveals that high-dose
clopidogrel is not effective enough and confirms the need for fast
and strong platelet inhibition. It reminds us also that the first
contact with the patient must be rapid and medical. Until now, only
well-organized hospital systems have been able to provide such a
service."
The special issue of
The Lancet also features an article about a study that says
while a combination therapy of angiotensin-converting enzyme (ACE)
inhibitors and angiotensin receptor blockers (ARB) reduces more
excess protein in the urine (proteinuria) than either therapy alone
in patients at high vascular risk, it could also result in greater
kidney damage.
Proteinuria can be a sign of kidney damage, as malfunctioning
kidneys allow proteins into the urine. Diabetes is the most common
cause of proteinuria, although a range of other conditions can
cause it.
An accompanying comment by doctors from University of
Thessaloniki in Greece and the University of Chicago concluded
"these data should not lead to guideline modifications ... Combined
with previous studies, [this study] supports the notion that use of
single agents to block the renin-angiotensin system is
well-tolerated."
More information
The U.S. Heart, Blood, and Lung Institute has more about
current heart attack treatments.
