March 16, 2006
DrRich spent a busy week in Atlanta attending the 2006 Scientific Sessions of the American College of Cardiology.
I will be writing more about some of the new information to come out of these meetings, but I want to give a quick briefing on the three issues that, in my opinion, will have the greatest general impact.
1) In patients with known vascular disease and many risk factors for heart attack, the use of clopidogrel (Plavix) was not effective in reducing the risk. There was even a suggestion of increased risk when clopidogrel was used in these patients. The first question that will occur to those who are already taking clopidogrel is: should I continue taking it? It is important to note that this new data applies onlyto the type of patient enrolled in this study - it does not apply to patients currently taking clopidogrel for approved indications. Specifically, if you are taking this drug because you have received a stent, you should definitely continue taking it unless your doctor tells you to stop. If you have questions about your continued use of clopidogrel, be sure to talk to your doctor.
2) The use of high dose rosuvastatin (Crestor) for two years produced a reduction in coronary artery plaques. This news is exciting because it adds to the evidence that it is possible to improve coronary artery disease itself, not just to slow its progression, with medical therapy. The study extends previous observations that coronary artery disease could be arrested with statin drugs.
3) The notion that there may be a significant type of late risk with drug-coated stents - which DrRich reported here last year- finally came out of the closet, and was discussed in a public forum. Late, sudden occlusion of drug-coated stents is a particularly troublesome kind of restenosis, since it appears to occur extremely suddenly and without warning, and can cause sudden death. This is why your cardiologist may have changed his mind about how long you should take Plavix - from 3 months, to 6 months, to 12 months, to indefinitely - after your drug coated stent was put in. Fortunately, Plavix seems to greatly mitigate the risk of this problem - but late occlusion may well turn out to be the chink in armor of drug-coated stents.
Check back for more in-depth analyses of all 3 of these stories.
