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Pairing Two Drugs With Angioplasty May Offer Best Success In Treating Heart Attacks

DALLAS -- Combining a "super aspirin" with bursts of a clot-busting drug during an angioplasty for patients experiencing a heart attack could offer the best strategy to quickly and safely open clogged arteries, Duke University researchers said at the annual American Heart Association scientific sessions.

Results of a dose-ranging trial show that using abciximab and two low-dose boluses of reteplase 30 minutes apart provided complete blood flow to up to 35 percent more patients than using abciximab alone or abciximab and a single dose of reteplase.

If the findings are confirmed and expanded in a larger clinical trial, pairing the drugs with angioplasty may offer a new standard of care for heart attacks, said the trial leader, Dr. Magnus Ohman, a cardiologist at the Duke Clinical Research Institute.

"Most patients now receive either a clot-busting drug or angioplasty to treat their heart attacks. Combining both together, and adding a second 'super-aspirin' drug appears to offer a very high success rate and may represent an exciting new step in treating most heart attacks," Ohman said.

He added that previous studies have shown that using a clot-busting drug alone is significantly less effective in restoring full blood flow (46 percent of patients), compared with using the right dose of a clot-buster and a "super aspirin" (63 percent of patients in this study had full blood flow after an hour).

Abciximab, known under the trade name Reopro, has been dubbed the ultimate aspirin because it stops blood from clotting, and reteplase, known as r-PA, dissolves blood clots. Both drugs are federally approved and on the market.

The Phase II dose-ranging trial, known as SPEED (Strategies for Patency Enhancement in the Emergency Department) was undertaken to find the fastest and safest way to open clogged arteries in a patient experiencing a heart attack. It was conducted in 61 hospitals with 305 pati
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Contact: Renee Twombly
Twomb001@mc.duke.edu
919-684-4148
Duke University Medical Center
9-Nov-1998


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