Clot-Busting Drugs: One Size Doesn't Fit All
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Most importantly, patients should be aware that there are several options
and discuss the available choices with their doctor. "In the past, giving
heart attack patients a [clot-busting drug] within six hours was a knee-jerk
reaction," Davis says. "Now there are many other options. You should
ask your doctor if anything else could be done."
Davis and Powe agree that the major message from this study is that
physicians must look very carefully at all possible options for each specific
patient. "The big message here is: One size doesn't fit all," Powe
The study was funded by the Health Care Financing Administration, the Harry
and Jeanette Weinberg Foundation of Baltimore, and the Delmarva Foundation for
Medical Care in Easton, Md.
- Researchers have found that clot-busting drugs used to treat heart attacks
clearly help patients under age 75. But they do not help older patients, and
may even cause harm.
- In about 8,000 Medicare patients aged 65 to 86 who had a heart attack,
those under 75 receiving clot busters had a 6.8% death rate 30 days after the
heart attack. Nearly 10% of these patients died when they did not get the
drugs. But in the older patient group, those getting clot busters were 40% more
likely to die within 30 days of treatment.
- An observer notes physicians should take the results seriously and consider
options like angioplasty for patients who don't seem to benefit from