Orlando: Adding the anti-platelet drug clopidogrel to aspirin for the emergency treatment of heart attacks could save thousands of lives a year worldwide and prevent thousands of repeat heart attacks and strokes, according to new research presented today (Wednesday 9 March) at the American College of Cardiology annual conference.

The study also established that giving the beta-blocker metoprolol as an emergency treatment for heart attacks cuts the risks of repeat heart attacks and of ventricular fibrillation^[1]. But, early use of beta-blocker treatment raises the risk of cardiac shock in the immediate aftermath of a heart attack, and these early benefits and hazards tend to cancel each other out.

The findings are from the 45,852-patient COMMIT/CCS-2 randomised study^[2] the largest ever conducted in China and the second largest study of emergency heart attack treatment in the world. This five-year joint Chinese/British venture involving 1,250 hospitals was organised by the Fuwai Hospital, Chinese Academy of Medical Sciences, Beijing, China, and the Clinical Trial Service Unit (CTSU) of Oxford University, UK.

Aspirin and clopidogrel are anti-platelet drugs that prevent blood clots through different mechanisms. The use of aspirin for the emergency treatment of heart attacks had been shown previously to reduce the risk of death and repeat heart attacks by about one quarter. The objective of COMMIT/CCS-2 was to see whether adding clopidogrel to aspirin might be even more beneficial than aspirin alone.

Beta-blockers are proven effective long-term treatment in the years after a heart attack. But, their value as emergency treatment is uncertain and such use is limited, although current guidelines advise prompt administration unless there are contraindications. COMMIT/CCS-2 aimed to establish whether using intravenous then oral metoprolol during a heart attack could cut deaths and reduce the risk of repeat heart attac
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Contact: Margaret Willson
m.willson@mwcommunications.org.uk
44-153-677-2181
MW Communications
9-Mar-2005

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