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Victims of angina can take heart from drug
Heart attacks, deaths to heart failure and the need for invasive surgery could be reduced by 25% with a new drug, according to a report.
The study, undertaken by the international medical steering committee, OASIS, in 15 countries, showed, at the end of a three-day intravenous treatment with lepirudin, that patients with unstable angina were less likely to suffer a heart attack or die due to heart failure. As part of the programme, over 10,000 patients at 360 hospitals world-wide were given the drug for a 72-hour period by intravenous infusion.
It was found that the combined rate of cardiovascular death and heart attack in the people taking lepirudin was reduced by 24% at the end of the three days. Also, the rate of cardiovascular death, heart attack and angina was reduced by 22%. According to the OASIS steering committee, unstable angina causes up to two million hospital admissions annually in north America and Europe, accounting for half of all emergency room visits for acute chest pain.
The treatment of patients is normally involves the administration of aspirin, intravenous heparin and intravenous nitrates. If patients cannot be stabilised by drugs, catheter, angioplasty or coronary bypass surgery are performed. However, despite this aggressive strategy, up to 6% of unstable angina patients will either have a heart attack or die while still in hospital. According to OASIS, the benefits of the three-day lepirudin treatment was maintained throughout the 35-day follow-up period. It was found that, after treatment was discontinued, deaths, heart attacks and clots in the coronary arteries occurred at the same rate as before. The study also found reductions in new incidents of heart failure, as well as the need for intervention procedures, such as angioplasty.
Nevertheless, while anti-coagulant drugs are intended to prevent unwanted clotting, they also, unavoidably, limit desired clotting, according to the study. In the OASIS study, after seven days, a significant increase in bleeds was seen in lepirudin-treated patients. According to Dr Alexander G. Turpie, professor of McMaster University, Canada and a member of the OASIS steering committee, however, treating patients with lepirudin prevents seven deaths or heart attacks and 14 invasive procedures for every 1,000 people treated. "The data from the OASIS studies provide new perspectives about the management of unstable angina patients," said Prof Yusuf. "Stabilising the patient with lepirudin treatment may provide a viable option to early catheterisation and angioplasty," he added.