NCPA - National Center for Policy Analysis

CLOT-BUSTER BEFORE ANGIOPLASTY INCREASES RISK

September 15, 2005

The common practice of giving heart attack patients a clot-busting drug within hours of planned angioplasty could be dangerous, an important new study suggests.

Many doctors give the clot-dissolver hoping it will make the artery-widening operation more successful. But research presented recently at the annual conference of the European Society of Cardiology found that more patients died in the month after the procedure if they were given the drug.

According to researchers:

  • Half of 1,667 patients in hospitals were given the clot-buster while en route to angioplasty, while the other half were given a fake pill.
  • The researchers found that 6 percent of patients who got the drug, TNKase, died within 30 days of the angioplasty, compared with 3.8 percent of those who had only the angioplasty.
  • The study, which was supposed to enroll 4,000 patients, was stopped prematurely once the difference in death rates between the two groups became apparent.

Experts expect the findings to prompt many doctors to stop using the strategy, at least for now.

Presently, there are two main options for treating heart attack victims -- a clot-dissolving drug or angioplasty, in which doctors thread a wire through the blood vessels to reach and break up the blood clot that caused the heart attack.

They then inflate a balloon to squash plaque against the artery wall and implant a tiny mesh tube at the site of a blockage to permanently prop the artery open.

Angioplasty is considered more effective than the drug option, but most community hospitals lack such expertise. There, patients are treated with a clot-busting drug or transferred to a hospital that can perform the angioplasty within three hours.

Source: Emma Ross, "Study: Clot-buster Before Angioplasty Increases Risk," Indianapolis Star, September 11, 2005.

 

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