Standard Dose of Blood Thinner May Not Be Best for All Patients11/06/12
TUESDAY, Nov. 6 (HealthDay News) -- Seventy-five percent of
patients taking the widely used blood thinners clopidogrel (Plavix)
and prasugrel (Effient) are getting the incorrect dose and could be
at risk for serious problems such as uncontrolled bleeding or blood
clots, a new study contends.
Millions of Americans with coronary artery disease take the
drugs to prevent blood clots that could cause a heart attack or
stroke. Guidelines recommend that all patients take the same
standardized dose, but that dose is not effective for all patients,
according to researchers at the Intermountain Medical Center Heart
Institute in Salt Lake City.
The researchers looked at more than 500 patients and found that
half of patients taking Plavix were getting too little of the drug
to most effectively prevent blood clots, while a quarter were
getting too much. Only a quarter were receiving an appropriate
Among patients taking Effient, half were taking too much of the
drug, which could lead to dangerous bleeding. A quarter were taking
too little of the drug and a quarter were taking the appropriate
The researchers also concluded that indicators like age, gender,
cholesterol levels and history of heart problems were not good
predictors for how a patient would react to the blood thinners.
"There's a sweet spot, an appropriate range for each patient. But we found that not many people are falling into that range," cardiac researcher Dr. Brent Muhlestein said in an institute news release.
"We showed that by performing a simple blood test to see whether or not the blood is clotting properly, we can determine whether patients are getting an appropriate, individualized dose of the medications," he added. "The test is easy to perform, but not widely used."
The study was presented Tuesday at the American Heart
Association annual meeting in Los Angeles. The data and conclusions
should be viewed as preliminary until published in a peer-reviewed
The U.S. Agency for Healthcare Research and Quality has more
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