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New anti-platelet cuts heart risk

By Lilian Anekwe

A successor to clopidogrel cuts cardiovascular events by a further 20% when used with aspirin in patients with acute coronary syndrome.

Some 13,068 patients with acute coronary syndrome in 30 countries were randomised to either prasugrel or clopidogrel for six to 15 months, after which those on the newer drug were 19% less likely to suffer a cardiovascular event, non-fatal heart attack or stroke.

Prasugrel treatment also resulted in improvements in secondary outcomes – including a 24% reduction in heart attacks and a 52% reduction in stent thrombosis.

The benefits of prasugrel were clinically significant after three days, and maintained at 30 and 90 days after treatment, said researcher Dr Elliott Antman, head of the cardiovascular division of the Brigham and Women's hospital in Boston.

‘We estimate that for every 1,000 patients treated with prasugrel, 23 cardiovascular events and six major bleeds are prevented,' he said.

Despite impressive efficacy data, doubts were still expressed by delegates about the drug's safety profile.

Dr George Kassianos, a GP in Bracknell, Berkshire, heard the results being presented and said he was concerned about a potential risk of colon cancer.

‘What concerned me was they noted a higher rate of adverse events related to colonic cancer in patients given prasugrel. They just glossed over it – but it needs to be explained,' he said.

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