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FAQ on the Anticlotting Drug Plavix

Pros and Cons of Plavix for Atrial Fibrillation and Patients With Stents
WebMD Health News
Reviewed by Louise Chang, MD

April 3, 2009 -- The anticlotting drug Plavix was in the news again this week, with researchers reporting that the drug helped to prevent strokes and heart attacks in people who suffer from a common heart rhythm disorder that puts them at risk for stroke.

The researchers studied over 7,500 people with atrial fibrillation. Over a nearly four-year period, those who took Plavix and aspirin were 11% less likely to suffer an "event" -- heart attack, stroke, blood clot, or death due to cardiovascular disease -- than those who took aspirin alone.

Findings of the study, called ACTIVE-A, were presented at the annual meeting of the American College of Cardiology (ACC). They were also published online by the New England Journal of Medicine.

Millions of Americans who have had stents implanted to open up clogged arteries already take Plavix. The new findings do not affect these people, but open up a potential new use for the drug.

WebMD looked into many common questions about Plavix. Here is what we found.

What is Plavix?

Plavix is an anti-platelet drug. It discourages the formation of blood clots, which helps prevent heart attacks and strokes caused by clots.

Why is Plavix given after stent implantation?

Stents are tiny mesh tubes used to prop open an artery after a balloon angioplasty opens a clog.

Bare-metal stents sometimes clog. Newer, drug-coated (or drug-eluting) stents also clog, although not nearly as often. But they take much longer to heal -- increasing the risk of a deadly blood clot forming at the site of the stent.

Blood-thinning treatment with a combination of Plavix and aspirin is given to help prevent these clots in people given stents.

Does Plavix treatment carry risks?

A chief risk is bleeding, says American Heart Association spokesman Jonathan Halperin, MD, director of clinical cardiology services at the Cardiovascular Institute at Mt. Sinai Medical Center in New York City.

Bleeding is often occult, or hidden, he says. Signs of bleeding that should immediately be reported to your doctor include dark or bloody urine; black, tarry stools; and easy, unusual bruising.

Bleeding can also lead to anemia, with symptoms of weakness and fatigue.

Your doctor can perform occult blood stool tests and blood tests to find out if you suffer from occult bleeding and/or anemia.

Other side effects of Plavix include diarrhea and allergic reactions that can cause rash or hives.

How long should people with drug-coated stents take Plavix?

There's been a big debate about this in recent years. Originally, the FDA recommended that people take Plavix, in combination with aspirin, for three to six months after stent implantation. Then, some studies suggested that people who stopped taking Plavix/aspirin treatment after three to six months had higher rates of heart attack and death than those who continued to take it. As a result, many doctors recommended that people stay on Plavix unless there was a reason to stop taking it.

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