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Study Shows How Drugs Help Bridge Stent Patients To Surgery

Wed, 01/18/2012 - 5:37am

(PRNewswire) New findings from a research study led by physicians at Scripps Health reveal that the investigational drug Cangrelor has the unique properties of achieving very fast blood thinning effects when needed to protect from heart attacks, but also dissipates rapidly so patients can undergo surgery without the excessive bleeding often associated with blood thinning medications.

Initial results from the BRIDGE trial will be published in the Journal of the American Medical Association (JAMA) and posted on its website. Launched in January 2009, the BRIDGE trial tests the efficacy of Cangrelor, an investigational intravenous anti-platelet that allows patients to be bridged from the time that their physicians stop their oral antiplatelet drugs until they undergo cardiac surgery. Study results demonstrated Cangrelor maintained target levels of platelet inhibition known to be associated with a low risk of blood clotting events, such as stent thrombosis.

The BRIDGE trial was led by primary investigator Eric Topol, MD, chief academic officer at Scripps Health and director of the Scripps Translational Science Institute (STSI). "For the first time we have validated a way to prevent clotting in patients who have had a recent stent but still require medication as they bridge to another surgery. This represents a fairly common clinical situation - the unplanned operation in a patient with a recent stent," said Topol.

Results of the trial showed 99 percent of Cangrelor-treated patients maintained target levels of platelet inhibition for all time points measured over the bridging period, compared to 19 percent of placebo patients with no significant excess in surgical bleeding complications. Patients who have had heart attacks or who have been treated with stents are commonly treated with blood thinning medications to help prevent future cardiovascular events. The most commonly used blood thinning medications for these patients are aspirin and Clopidogrel (also known as Plavix).

Attention was brought to this issue in 2004 when former President Clinton presented with a mild (very small) heart attack that required urgent bypass surgery. He had received aspirin and Plavix, and as a result, had to wait six days before the surgery was performed. According to Topol, these considerations underscore the importance of identifying strategies for patients to be safely bridged to their surgical procedure with minimal risk of developing heart attacks or bleeding complications.

According to 2009 data from the Organisation for Economic Co-operation and Development (OECD), more than 2.5 million stent procedures are performed globally per year. Treatment guidelines in the United States and Europe recommend stent patients receive blood thinning medications for up to 12 months following their stent procedure. It is estimated that up to 25 percent of these patients with stents in place will require a surgical procedure during the first five years after.

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