Danish Study Assesses Use of Clopidogrel in Heart Failure

Drug is linked to reduced mortality in heart failure patients who don't have PCI after heart attack
By A. Agrawal, PhD
HealthDay Reporter

FRIDAY, March 26 (HealthDay News) -- Patients who have a heart attack and heart failure have a lower risk of death if treated with clopidogrel (Plavix), even though clopidogrel use is currently low in these patients, according to research published in the March 30 issue of the Journal of the American College of Cardiology.

Noting that clopidogrel reduces mortality in patients with acute myocardial infarction (AMI) but its use is low in patients who also have heart failure, Lisbeth Bonde, M.D., from Copenhagen University Hospital Gentofte in Hellerup, Denmark, and colleagues retrospectively analyzed data on clopidogrel use and mortality in 56,944 patients with first-time AMI and 5,050 matched patients with heart failure who were not undergoing percutaneous coronary intervention.

After a mean follow-up of 1.50 years, the researchers found that there were significantly fewer deaths among patients with heart failure who were treated with clopidogrel (28.1 versus 32.2 percent; hazard ratio, 0.86). In contrast, clopidogrel treatment had no significant effect on mortality in patients without heart failure (9.4 versus 9.7 percent; hazard ratio, 0.98) after a mean follow-up of 2.05 years.

"The current study demonstrated an association between clopidogrel and decreased mortality in patients with AMI and heart failure who do not undergo percutaneous coronary intervention," Bonde and colleagues conclude. "These patients have low initiation rates of clopidogrel, and the data suggest that increased awareness of the benefit of clopidogrel in such high-risk patients can have considerable clinical impact."

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