Aspirin-Plavix Combo: No Clear Edge
2 Drugs Together Are No Better at Preventing Heart Attacks Than Aspirin Alone
Some Benefits for Heart Patients continued...
The participants, who were all at least 45 years old, were randomly assigned to receive either aspirin plus Plavix or aspirin plus placebo for an average of 28 months.
A total of 6.8% of people on the Plavix combination suffered a heart attack, stroke, or died from cardiovascular causes, compared with 7.3% in the placebo group -- a difference so small that it could have been due to chance.
When the researchers looked only at the 12,153 people with established cardiovascular disease, however, the addition of Plavix did have benefit, with only 6.9% of them suffering a heart attack or stroke or dying vs. 7.9% on aspirin alone.
"This translates to a significant 12% reduction in risk," Bhatt says.
But the 3,284 patients with multiple risk factors were nearly 50% more likely to die from cardiovascular causes, he says. In this subgroup, 3.9% of Plavix users died vs. 2.2% on placebo. People taking Plavix were also more likely to suffer moderate bleeding, he says.
Marc A. Pfeffer, MD, PhD, of Harvard Medical School, and John A. Jarcho, MD, of The New England Journal of Medicine, write that the risks and costs of the combination therapy appear to outweigh the benefits for the people studied.
"The absence of a clear benefit in terms of outcome, coupled with an increased rate of bleeding ... argues against the use of dual antiplatelet therapy in this patient population," they write in an editorial accompanying the study.
Plavix is co-marketed by Sanofi-Aventis and Bristol-Myers Squibb Co., which funded the study. Both are WebMD sponsors.