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Study: Stopping Plavix May Be Risky

Risk of Death or Heart Attack May Be Higher in 3 Months After Stopping Plavix

By Miranda Hitti
WebMD Medical News
Reviewed By Louise Chang, MD

Feb. 5, 2008 -- Heart attack survivors and other heart patients may be more likely to die or suffer a heart attack in the first three months after stopping the drug Plavix, new research shows.

Plavix is an antiplatelet drug. It discourages the formation of blood clots, which helps prevent heart attacks and strokes caused by clots.

If confirmed, the findings from the new Plavix study may mean that researchers need to revisit the length of Plavix treatment and ways to transition off of Plavix.

The study appears in the Feb. 6 edition of The Journal of the American Medical Association.

Plavix Study

The new study on stopping Plavix included 3,137 U.S. veterans with acute coronary syndrome, meaning they had had a heart attack or had been hospitalized due to serious heart-related chest pain (unstable angina).

Almost all of the patients -- 98% -- were men. They were in their 60s on average. Many had a history of heart problems and other medical conditions.

Half of the patients only got drug treatments. The other half got stents inserted to hold open narrowed coronary arteries.
All of the patients got Plavix prescriptions when they left the hospital. They took Plavix for various lengths of time -- a little more than nine months on average. It's not clear if the patients stopped taking Plavix because their prescriptions ran out or if their doctors were concerned about bleeding risk or other conditions.

Stopping Plavix

The patients were followed for nearly seven months, on average, after stopping Plavix.

During that time, 17% of patients who had only gotten drug treatment and 8% of those who had gotten stents died or had a heart attack. Most of those cases happened in the first 90 days after stopping Plavix.

While rare overall, those deaths and heart attacks were nearly twice as common soon after stopping Plavix than they were later on.

If the results are confirmed, further studies may be needed to see if patients should take Plavix longer, taper off Plavix, or use other drugs to lower death and heart attack risk, note the researchers.
They included P. Michael Ho, MD, PhD, of the Denver VA Medical Center and the University of Colorado Health Sciences Center.

SOURCES: Ho, P. The Journal of the American Medical Association, Feb. 6, 2008; vol 199: pp 532-539. WebMD Drug Reference from First Data Bank: "Plavix." News release, JAMA/Archives.