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Heart attack study hails effect of anti-clotting drug

15/08/2008

Thousands of lives could be saved every year by greater use of anti-clotting drugs for heart attack patients, a study has claimed.

Research conducted in northern Europe says patients administered with anti-platelet drug tirofiban while being taken to hospital have a "significantly" higher chance of survival.

The study's authors, from the Department of Cardiology in Zwolle, the Netherlands, are advocating the use of the drug in ambulances as a replacement to the combined use of aspirin, heparin and clopidogrel for ST-elevated myocardial infarction (STEMI) patients.

To arrive at their findings researchers studied the records of almost 1,000 patients from 24 health centres in Belgium, the Netherlands and Germany between June 2006 and November 2007.

They found that ST deviation [a measure of the severity of the blockage affecting the heart] on the patients' electrocardiograms was significantly lower in the tirofiban group than the placebo group.

Major bleeding did not differ significantly between the two groups, with four per cent of patients in the tirofiban group and three per cent in the placebo group suffering major bleeds.

"Our trial was not powered on a difference in clinical outcome between the two groups. However, we noted a better clinical outcome in the tirofiban group than in the placebo group, with lower overall mortality and less urgent repeat PCI," the authors, publishing their findings in the Lancet journal, write.

"Our finding that routine prehospital initiation of high-bolus dose tirofiban improved ST-segment resolution and clinical outcome after PCI, emphasises that further platelet aggregation inhibition besides high-dose clopidogrel is mandated in patients with STEMI undergoing PCI."