Anti-clotting Drugs Present Big Risk

Giving patients a clot-busting drug before planned angioplasty, a common practice nowadays, has been recently found to be dangerous.

Clot dissolvers are usually given to patients a few hours before angioplasty in the hope that it will make the operation more successful. However, the recent research led by Dr. Frans Van de Werf of the Catholic University of Leuven in Belgium has proved that more patients who were given the drug died within the following month after angioplasty than patients who were not. The findings were presented at the annual conference of the European Society of Cardiology in Stockholm, Sweden.

Angioplasty is one of the options available for treating heart attack victims, apart from clot dissolver treatment. It is considered a very effective option, when performed by experienced doctors in well-equipped hospitals. Angioplasty implies threading a wire through the blood vessels to mechanically break up the clot that caused the heart attack. A balloon is inflated to squash plaque against the walls of the artery, and then a tiny mesh tube is implanted at the site of a blockage, to keep the artery open permanently.

When a hospital does not have the necessary expertise to perform such an operation, patients are either treated with a clot-dissolving drug or transferred to another hospital, to have the angioplasty performed within the next 3 hours. It is not clear, however, if the use of a clot-buster is beneficial in cases where angioplasty can be performed, but only within 1-3 hours after the heart attack.

The current study compared strategies among 1,667 patients in various hospitals, half of which were given a clot-buster before angioplasty; the other half were administered a fake pill.

6% of the patients who received the drug (TNKase) died within the next month following the angioplasty, as compared to only 3.8%, in the group who took fake pills. The study was stopped prematurely, immediately after this big difference in death rates became clear.

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