March 17, 2006
The American Heart Association published a special on-line advisory to patients in light of the highly-publicized report from the CHARISMA trial this week. ( Read DrRich's commentary on the CHARISMA trial here.) The CHARISMA trial showed that, in patients with stable coronary artery disease, the use of clopidogrel (Plavix) was not effective in preventing cardiovascular events. Worse, there was a trend toward morecardiovascular events and death with Plavix in one subgroup of patients (those with multiple risk factors for coronary artery disease but in whom actual coronary disease had not been diagnosed.) The AHA is - appropriately - concerned that patients who should be taking Plavix might stop taking it after hearing news reports on the CHARISMA trial.
Their advisory tells patients that Plavix has been shown in many clinical trials to prevent cardiovascular events in less stable patients with coronary artery disease, and that patients currently taking Plavix for approved indications should not stop taking it without first consulting with their doctors. These approved indications include:
- some patients who have had a heart attack
- patients who have had angioplasty for unstable angina or heart attack
- patients who have received a stent (drug coated or bare metal)
- patients with peripheral artery disease
- patients who have had transient ischemic attacks (mini stroke), or some other types of stroke
