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Drug Reduces Heart Attack, Death Rates In Patients With Unstable Angina

DURHAM, N.C. -- An international study of heart patients indicates a newly approved drug, Eptifibatide, could reduce heart attack and death during the critical month following hospitalization for up to 35,000 Americans annually with a particular heart condition. Results of the study are published in the Aug. 13 issue of the New England Journal of Medicine.

Led by researchers at Duke University Medical Center and Erasmus University in Rotterdam, The Netherlands, the clinical trial is the largest ever conducted on patients with unstable angina or "acute coronary syndrome." The condition occurs when blood clots form around ruptured bits of plaque in the arteries, resulting in reduced blood flow to the heart. Patients typically experience chest pain and weakening of the heart muscle and the condition, if left untreated, can lead to heart attack and death.

Although current treatments like aspirin and heparin are successful at inhibiting blood clots, they do not work in every patient. So clinicians are continually searching for alternative treatments that will work in different segments of the population, said Dr. Robert Harrington, assistant professor of medicine at Duke.

The drug Eptifibatide, originally tested to reduce complications during and after angioplasty, was studied in the present trial on 10,948 patients in 27 countries to confirm its benefits in patients with unstable angina. Researchers said the drug works by inhibiting the receptor that causes platelets to bind together and form a clot. While aspirin works through a similar mechanism, it only inhibits one of many pathways leading to the receptor, whereas Eptifibatide inhibits the receptor itself. Another current treatment, heparin, inhibits thrombin, but this enzyme is involved in another part of the clot-forming process.

Eptifibatide's different mechanism of action means patients already taking aspirin or heparin may be able to add Eptifiba
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Contact: Rebecca A. Levine
Levin005@mc.duke.edu
(919) 684-4148
Duke University Medical Center
12-Aug-1998


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