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Heart Disease Health Center

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New Anticlotting Drug May Extend Heart Patients' Lives

Study Shows Xarelto Helps Treat People Who Had Heart Attacks or Chest Pain
WebMD Health News
Reviewed by Laura J. Martin, MD

Nov. 14, 2011 (Orlando, Fla.) -- People recently hospitalized for heart attack or the severe chest pain of angina may live longer if they take the new anticlotting pill Xarelto in addition to standard treatment, a large study shows.

There was a drawback to taking Xarelto: an increased risk of serious, but non-deadly, bleeding, including bleeding in the brain.

Still, "death trumps nonfatal bleeding in most people's mind," so overall Xarelto is a substantial advance for these people, says Paul Armstrong, MD, a cardiologist at the University of Alberta in Edmonton, Canada. Armstrong was not involved with the study.

The study was presented here at the American Heart Association (AHA) annual meeting. It was also published online by The New England Journal of Medicine.

Targeting Acute Coronary Syndrome

The study involved more than 15,500 people who had been hospitalized for acute coronary syndrome within the past week. Acute coronary syndrome (ACS) describes conditions such as heart attacks and angina (heart-related chest pain) that occur because of reduced blood flow to the heart.

Xarelto (rivaroxaban) is approved by the FDA to prevent strokes in people with an abnormal heart rhythm called atrial fibrillation (AF) and to prevent the formation of blood clots after hip and knee replacement surgeries.

It works in a different way than aspirin and older anticlotting drugs like Plavix.

Based on the new findings, Johnson & Johnson, which makes the drug and funded the study, plans to apply for FDA approval for use in people with acute coronary syndrome by the end of the year.

At least 671,000 Americans were discharged from the hospital with ACS in 2007, the latest year for which figures are available, according to the AHA.

A price for use of Xarelto in treating ACS has not been set. A much higher dose used for stroke prevention in people with AF costs about $7 a day, according to Johnson & Johnson.

Xarelto for Acute Coronary Syndrome

In the study, everyone got low-dose aspirin, usually with the standard anticlotting drug Plavix. One-third also got a low dose of Xarelto, one-third got a very low dose of the drug, and the rest got a placebo. The pills were given twice daily for an average of 13 months.

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