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New life-saving pill for heart disease sufferers

A blood-thinning drug which could prevent one in five heart attacks, strokes or heart disease deaths among Britons is being hailed as a major breakthrough by doctors. Results from a landmark study released today are expected to lead to much wider use of Plavix, a clot- stopping agent dubbed the 'new aspirin of the 21st century'.

They show that, when the drug is used in combination with aspirin, up to 10,000 deaths, heart attacks or strokes could be averted among patients needing urgent hospital treatment each year. Eventually, experts predict, dual-therapy of Plavix and aspirin will become the standard long-term preventive treatment after heart attacks.

The CURE trial - which involved 750 British patients out of 12,500 taking part in 28 countries - found the drug, also known as clopidogrel, increased the effectiveness of standard therapy.

Dr Marcus Flather, cardiologist at the Royal Brompton Hospital, London, who led the British team with Professor Keith Fox of Edinburgh University, said patients could get huge benefits from the drug combination.

He said: 'These results come along once every ten years. It is probably the biggest breakthrough in the treatment of coronary heart disease, the UK's number one killer, since the introduction of aspirin in the 1980s.

'Clopidogrel taken with aspirin will provide dramatic benefits to a wide range of patients. The beauty of it all is that it's a simple treat-ment - all patients need do is take a single tablet each day.'

Professor Fox said: 'These are really exciting results. For the first time, we have the potential to really improve the management of patients with acute coronary syndromes, especially over the longer term when patients remain at a high risk of events.'

Patients with acute coronary syndromes are those with severe or unpredictable chest pain, called unstable angina, or who have suffered mild heart attacks known as non-Q-wave attacks.

In Britain, around 30,000 such patients are admitted to hospital for urgent treatment each year. But the CURE trial suggests 5,000 to 10,000 could be saved from suffering further attacks, strokes or even dying from their condition.

All the patients in the trial were given standard treatment, but half were randomly assigned to take Plavix every day.

After one year, 9.3 per cent of patients on Plavix had suffered a stroke or new heart attack or had died of cardiovascular disease compared with 11.5 per cent of patients getting standard treatment.

The reduced risk of such major events was around 20 per cent, according to results published in the New England Journal of Medicine and The Lancet.

The study shows that using Plavix could prevent 28 life-threatening events for every 1,000 patients treated over nine months.

The only important side- effect was bleeding, which would mean six patients per 1,000 needing a transfusion over the nine-month period.

The drug is mainly used after angioplasty - balloon treatment for blocked arteries - to thin the blood both in the U.S. and the UK and the study shows patients getting dual therapy had a 31 per cent cut in the risk of a heart attack or dying after the procedure.

Plavix is licensed for use after heart attacks and strokes for people intolerant of aspirin. It is made by Sanofi-Synthelabo and Bristol-Myers Squibb, who funded the study.

Like aspirin, Plavix affects the blood's clotting action, making it less likely that life-threatening clots will develop in diseased arteries. But the new drug has a mechanism that combines with aspirin to make treatment more effective.

One quarter of a million people die every year in the UK from heart disease, one of the world's highest rates. It costs the UK economy £10billion a year.

Dr Flather said the new drug was not expensive, costing £1 a day, and specialists at the Royal Brompton are already offering dual therapy to patients at risk, even though it was not yet licensed for this purpose.

He said: 'Licensing approval has been applied for but we think these results are so important that all clinicians should be offering it now.'