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Warning on treating MI with long-term clopidogrel

By Yvette Martyn

GPs treating patients at risk of recurrent myocardial infarction with clopidogrel may be keeping some of them on the drug for far longer than necessary, researchers believe.

Their study of 12,000 patients found those on clopidogrel for six months after a percutaneous coronary intervention (PCI) had similar rates of death and recurrent MI as those on the medication for 12 months.

Adopting a shorter time period could be beneficial in reducing the occurrence of bleeding, said the researchers. Bleeding occurred in 3.5% of patients in the six-month regimen and 4.1% in the 12-month regimen.

Their study used registers of hospitalisations and drug dispensing from pharmacies to identify patients admitted with MI, and treated with PCI and clopidogrel.

Rates of death, recurrent MI or a combination of both were analysed using the Kaplan Meier method and Cox proportional hazards models.

Study author Dr Rikke Sørensen, a research fellow from Copenhagen University Hospital Gentofte, said: ‘The potential benefit of prolonged clopidogrel treatment in real life settings remains uncertain.'

NICE currently recommends that patients are treated with clopidogrel in combination with low-dose aspirin for up to 12 months after the most recent episode of non-ST-segment-elevation acute coronary syndrome.

BMC Cardiovascular Disorders 2010, 10:6.

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